title: Depressive symptoms, serious psychological distress, diabetes distress and cardiovascular risk factor control in patients with type 2 diabetes.
abstract: OBJECTIVE
  This study examined the association between cardiovascular disease (CVD) risk factor control and elevated depressive symptoms (EDS), serious psychological distress (SPD), and diabetes distress (DD) in patients with type 2 diabetes (T2DM).
  
  
  METHODS
  This was a cross-sectional study of adults seen at an academic medical center and Veterans Affairs Medical Center in the southeastern US. Linear regression models were computed using CVD risk factors as clinically meaningful outcomes (glycosylated hemoglobin A1c (HbA1c); systolic (SBP) and diastolic (DBP) blood pressure; and low-density lipoprotein cholesterol (LDL-C)); EDS, SPD, and DD were primary independent variables. Covariates included sociodemographics and comorbidities.
  
  
  RESULTS
  The sample consisted of 361 adults. Correlation analyses showed significant relationships between DD and HbA1c, DBP, and LDL-C. Adjusted linear regression models showed DD to be significantly associated with HbA1c and LDL-C, and SPD to be significantly associated only with LDL-C. In the fully adjusted model, DD remained significantly associated with HbA1c (β=4.349; 95% CI (-0.649, 2.222)).
  
  
  CONCLUSIONS
  In this sample of adults with T2DM, DD and SPD were significantly associated with CVD risk factors; however, after controlling for covariates, only DD was shown to be significantly associated with poor glycemic control.
  
  
  CONCLUSIONS
  Strategies are warranted to examine the relationship between DD and CVD risk factor control in patients with T2DM.
authors.affiliation: Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, P.O. Box 250593, Charleston, SC USA 29425. Electronic address: runwithjane@gmail.com.
authors.forename: Rhonda J
authors.initials: RJ
authors.lastname: Winchester
authors.affiliation: Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, P.O. Box 250593, Charleston, SC USA 29425; Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 803, MSC 623, Charleston, SC USA 29425. Electronic address: stromjl@musc.edu.
authors.forename: Joni S
authors.initials: JS
authors.lastname: Williams
authors.affiliation: Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 803, MSC 623, Charleston, SC USA 29425. Electronic address: wolfmant@musc.edu.
authors.forename: Tamara E
authors.initials: TE
authors.lastname: Wolfman
authors.affiliation: Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, P.O. Box 250593, Charleston, SC USA 29425; Department of Medicine, Division of General Internal Medicine and Geriatrics, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 803, MSC 623, Charleston, SC USA 29425; Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson VA Medical Center, 109 Beet Street, Charleston, SC USA 29401. Electronic address: egedel@musc.edu.
authors.forename: Leonard E
authors.initials: LE
authors.lastname: Egede
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000453:epidemiology* / Q000523:psychology* / Q000628:therapy; D003925:Diabetic Angiopathies / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Cardiovascular disease risk factor; Depressive symptoms; Diabetes; Diabetes distress; Serious psychological distress