The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes.
OBJECTIVE
To clarify previous findings that diabetes distress is related to glycemic control and self-management whereas measures of depression are not, using both binary and continuous measures of depression.


METHODS
Four hundred and sixty-three type 2 patients completed measures of diabetes distress (Diabetes Distress Scale [DDS]) and clinical depression (Patient Health Questionnaire 8 [PHQ8]). PHQ8 was employed as either a binary (>or=10) or continuous variable. Dependent variables were A1C, diet, physical activity (PA), and medication adherence (MA).


RESULTS
The inclusion of a binary or continuous PHQ8 score yielded no differences in any equation. DDS was significantly associated with A1C and PA, whereas PHQ8 was not; both DDS and PHQ8 were significantly and independently associated with diet and MA.


CONCLUSIONS
The lack of association between depression and glycemic control is not due to the use of a binary measure of depression. Findings further clarify the significant association between distress and A1C.
Department of Family and Community Medicine, University of California, San Francisco, California, USA. fisherl@fcm.ucsf.edu
Lawrence
L
Fisher
Russell E
RE
Glasgow
Lisa A
LA
Strycker
D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D000368:Aged; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006304:Health Status; D006801:Humans; D006943:Hyperglycemia / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012648:Self Care / Q000523:psychology* / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human