title: Depressive symptoms are associated with physical inactivity in patients with type 2 diabetes. The DIAZOB Primary Care Diabetes study.
abstract: BACKGROUND
  Depression is a common complication of type 2 diabetes, associated with poor disease outcomes such as impaired glycaemic control, cardiovascular disease and increased mortality. The mechanisms behind these associations are unclear. Depression might contribute to poor disease outcomes through decreased physical activity.
  
  
  OBJECTIVE
  To test whether type 2 diabetes patients with elevated depression scores are more often physically inactive.
  
  
  METHODS
  Demographic features, clinical factors, level of physical inactivity and depressive symptoms were assessed in 2646 primary care patients with type 2 diabetes. Sequential multiple logistic regression analyses [odds ratio, 95% confidence interval (CI)] were performed to test the association between depressive symptoms and physical inactivity.
  
  
  RESULTS
  About 48% of the respondents were physically inactive. Elevated depressive symptoms were found in 14% of the respondents. After adjustment for potential confounders, the odds for being physically inactive were almost doubled in depressed patients with type 2 diabetes 1.74 (95% CI 1.32-2.31).
  
  
  CONCLUSIONS
  Presence of depressive symptoms almost doubles the likelihood of physical inactivity in patients with type 2 diabetes. Longitudinal studies are needed to investigate whether physical inactivity forms the link between depression and poor disease outcomes.
authors.affiliation: Centre of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, Tilburg, The Netherlands.
authors.forename: Berber
authors.initials: B
authors.lastname: Koopmans
authors.forename: François
authors.initials: F
authors.lastname: Pouwer
authors.forename: Robert A
authors.initials: RA
authors.lastname: de Bie
authors.forename: Elisabeth S
authors.initials: ES
authors.lastname: van Rooij
authors.forename: Geraline L
authors.initials: GL
authors.lastname: Leusink
authors.forename: Victor J
authors.initials: VJ
authors.lastname: Pop