title: Diabetes distress, but not depressive symptoms, is associated with glycaemic control among Japanese patients with type 2 diabetes: Diabetes Distress and Care Registry at Tenri (DDCRT 1).
abstract: OBJECTIVE
  To investigate the association between glycaemic control, diabetes distress and depressive symptoms among Japanese patients with Type 2 diabetes.
  
  
  METHODS
  Cross-sectional data from 3305 patients with Type 2 diabetes were obtained from a baseline assessment of a diabetes registry at a general hospital in Japan. The Centre for Epidemiologic Studies Depression scale and Problem Areas in Diabetes scale were used to measure depressive symptoms and diabetes-related distress, respectively. Modified Poisson regression analysis was used to estimate the relative risks for poor glycaemic control across the quartiles of Centre for Epidemiologic Studies Depression scale and Problem Areas in Diabetes scale scores.
  
  
  RESULTS
  The average age of the participants was 64.9 years and the average HbA(1c) level was 58.1 mmol/mol (7.5%). Clinically significant levels of depressive symptoms (Centre for Epidemiologic Studies Depression scale scores ≥ 16) were reported by 27.8% of participants. These scores significantly correlated with Problem Areas in Diabetes scale scores (r = 0.4354, P < 0.0001). Diabetes distress, but not depressive symptoms, was significantly associated with higher HbA(1c) levels. The relative risks for poor glycaemic control (HbA(1c) ≥ 64 mmol/mol; 8.0%), when adjusted for age, sex, BMI, type of diabetes therapy and duration of diabetes, was 67% higher among patients with Problem Areas in Diabetes scale scores in the highest quartile (≥ 26.25) compared with those in the lowest quartile (0-3.75).
  
  
  CONCLUSIONS
  A significant association between glycaemic control and diabetes-related distress, but not depressive symptoms, was observed in Japanese patients with Type 2 diabetes.
authors.affiliation: Diabetes Centre, Tenri Hospital, Tenri, Japan. stsujii@tenriyorozu.jp
authors.forename: S
authors.initials: S
authors.lastname: Tsujii
authors.forename: Y
authors.initials: Y
authors.lastname: Hayashino
authors.forename: H
authors.initials: H
authors.lastname: Ishii
mesh_terms: D000368:Aged; D001007:Anxiety / Q000097:blood / Q000453:epidemiology*; D044466:Asian People / Q000706:statistics & numerical data*; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism*; D003430:Cross-Sectional Studies; D003863:Depression / Q000097:blood / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012042:Registries; D013315:Stress, Psychological / Q000097:blood / Q000209:etiology*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human