title: Improvement in glycemic control following a diabetes education intervention is associated with change in diabetes distress but not change in depressive symptoms.
abstract: In diabetes patients, depression is correlated with diabetes-specific emotional distress, and observational studies have suggested that diabetes distress may have a greater impact on diabetes outcomes than depression itself. To examine the relative effects of change in depressive symptoms and change in diabetes distress on change in glycemic control, we conducted a diabetes self-management education intervention in 234 type 2 diabetes (T2DM) patients, and measured glycemic control (HbA1c), depressive symptoms (CES-D), and diabetes distress (PAID) at baseline and 6 months. In multiple linear regression, change in depressive symptoms was not associated with change in HbA1c (P=0.23). Change in diabetes distress was significantly associated with change in HbA1c (P<0.01), such that a 10-point decrease in diabetes distress (which corresponds to the average change in distress in this study population) was associated with a 0.25% reduction in HbA1c. Change in diabetes distress, and not change in depressive symptoms, was associated with both short- and long-term change in glycemic control for patients with poorly controlled T2DM.
authors.affiliation: Department of Behavioral Medicine Research, Baystate Medical Center, Springfield, MA 01105, USA. Sofija.Zagarins@baystatehealth.org
authors.forename: Sofija E
authors.initials: SE
authors.lastname: Zagarins
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Allen
authors.forename: Jane L
authors.initials: JL
authors.lastname: Garb
authors.forename: Garry
authors.initials: G
authors.lastname: Welch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D012648:Self Care; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology
chemical_list: D001786:Blood Glucose