title: The effects of depression on metabolic control and quality of life in indigent patients with type 2 diabetes.
abstract: BACKGROUND
  The objective of this study was to assess differences in metabolic control and health-related quality of life (QOL) among depressed and nondepressed adults in an indigent population with type 2 diabetes.
  
  
  METHODS
  Subjects completed validated surveys to assess depression and QOL. Depression was assessed with the Center for Epidemiological Studies-Depression Scale and defined as a score of > or =16. Metabolic control (hemoglobin A1C, total cholesterol, low-density lipoprotein [LDL] cholesterol, and high-density lipoprotein [HDL] cholesterol) measures were abstracted from medical records. We compared demographic characteristics, metabolic control, and QOL by depression status. Ordinary least squares regression was used to assess differences in QOL scores and metabolic control levels by depression status adjusting for covariates.
  
  
  RESULTS
  In the study sample (n = 201), approximately 20% (n = 40) were depressed. In unadjusted analyses, subjects with depression had significantly lower SF-12 physical component summary (PCS) scores (30.4 +/- 7.3 vs. 39.6 +/- 11.8, P < 0.001) and mental component summary (MCS) scores (32.8 +/- 10.5 vs. 48.9 +/- 9.2, P < or = 0.001) and significantly higher total cholesterol (209.3 +/- 72.1 vs. 186.6 +/- 50.9, P = 0.024) compared to those without depression. No significant differences were observed by depression status in hemoglobin A1C, LDL cholesterol, and HDL cholesterol. After adjustment for relevant covariates, depressed individuals continued to have lower SF-12 PCS (36.1 vs. 39.0, P < or = 0.001) and MCS (41.6 vs. 46.8, P < or = 0.001) scores, but the difference in total cholesterol levels was no longer significant.
  
  
  CONCLUSIONS
  In an indigent sample with type 2 diabetes, depression is significantly associated with decreased physical and mental components of QOL. This finding further reinforces the importance of addressing depression in all populations with type 2 diabetes.
authors.affiliation: Center for Health Disparities Research, Department of Medicine, Medical University of South Carolina, 135 Rutledge Avenue, Charleston, SC 29425, USA. egedel@musc.edu
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
authors.forename: Charles
authors.initials: C
authors.lastname: Ellis
mesh_terms: D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011788:Quality of Life
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human