title: Who benefits from diabetes self-management interventions? The influence of depression in the Latinos en Control trial.
abstract: BACKGROUND
  Depressive symptoms are common among adults with diabetes. Depression and social support may influence diabetes self-management.
  
  
  OBJECTIVE
  This study aimed to examine change in depressive symptoms and the role of depression and support on clinical and dietary outcomes among Latinos with type 2 diabetes participating in a diabetes self-management intervention.
  
  
  METHODS
  Participants (N = 252) were randomized to the intervention or usual care. Mixed effects models were used to examine interaction effects between intervention status and depressive symptoms (Centers for Epidemiologic Studies Depression (CES-D) score) and support for diabetes self-management behaviors at baseline. Outcomes were measured at baseline and 4 and 12 months and included dietary quality, physical activity, depressive symptoms, and hemoglobin A1c levels.
  
  
  RESULTS
  Intervention participants had lower CES-D scores at follow-up than control participants. An interaction effect between intervention status and CES-D scores predicted diet quality.
  
  
  CONCLUSIONS
  Latinos with depressive symptoms may derive the greatest benefits from diabetes self-management interventions. Additional research on support during diabetes self-management interventions is warranted.
authors.affiliation: Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA, Monica.Wang@umassmed.edu.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Wang
authors.forename: Stephenie C
authors.initials: SC
authors.lastname: Lemon
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Whited
authors.forename: Milagros C
authors.initials: MC
authors.lastname: Rosal
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003863:Depression / Q000150:complications / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000523:psychology* / Q000628:therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006630:Hispanic or Latino / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods*; D011569:Psychiatric Status Rating Scales; D012648:Self Care / Q000523:psychology*; D012944:Social Support; D055815:Young Adult
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human