title: Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring.
abstract: OBJECTIVE
  To determine whether the association between depressive symptoms and glycemic control is mediated by blood glucose monitoring (BGM).
  
  
  METHODS
  A total of 276 adolescents with type 1 diabetes (mean age +/- SD, 15.6 +/- 1.4 years) completed a measure of depressive symptoms. Sociodemographic and family characteristics were obtained from caregivers. BGM frequency and glycemic control were obtained at a clinic visit.
  
  
  RESULTS
  Separate regression analyses revealed that depressive symptoms were associated with lower BGM frequency (B = -0.03; P = 0.04) and higher A1C (B = 0.03; P = 0.05) and that lower BGM frequency was associated with higher A1C (B = -0.39; P < 0.001). With depressive symptoms and BGM frequency included together, only BGM frequency was associated with A1C and depressive symptoms became nonsignificant (B = 0.02; P = 0.19). The Sobel test was significant (Z = 1.96; P < 0.05) and showed that 38% of the depression-A1C link can be explained by BGM.
  
  
  CONCLUSIONS
  BGM is a mediator between depressive symptoms and glycemic control in adolescents with type 1 diabetes.
authors.affiliation: Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
authors.forename: Meghan E
authors.initials: ME
authors.lastname: McGrady
authors.forename: Lori
authors.initials: L
authors.lastname: Laffel
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
authors.forename: David
authors.initials: D
authors.lastname: Repaske
authors.forename: Korey K
authors.initials: KK
authors.lastname: Hood
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000032:analysis / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000523:psychology*; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000523:psychology*; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D017533:Marital Status; D000297:Psychology, Adolescent; D020377:Self Efficacy
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin