61-OR: Glycemic Control and Depressive Symptoms among Minority Women with Type 2 Diabetes Enrolled in the Women In Control (WIC2) Diabetes Medical Group Visit (DMGV) Study

Abstract

Background: Comorbid depression is associated with poor diabetes control. DMGVs improve glycemic control and depressive symptoms among patients with type 2 diabetes (T2DM). The WIC2 study compared the effectiveness of an eight-week DGMV conducted in a virtual world platform vs. an in-person format to improve diabetes outcomes for 288 minority women with uncontrolled T2DM (HbA1c ≥8.0%). Objective: We conducted a secondary data analysis of the WIC2 clinical trial data to examine the association between improvements in depressive symptom burden (PHQ-8) and improvements in HbA1c among participants enrolled in the WIC2 study. Methods: We measured mean changes in PHQ-8 and HbA1c at baseline, 9-weeks, and 6-months post-enrollment among 288 WIC2 participants. We performed logistic regression to examine the association between a reduction in depressive symptoms per PHQ-8 (-5 points) and reduction in HbA1c (-0.4%) at 9-weeks and 6-months. We used multivariable logistic regression to adjust for potential confounders, including age, education, and study arm. Results: At baseline, nearly half of WIC enrollees reported mild (29.5%), moderate (17.4), or severe (1.7%) depressive symptoms. Their mean PHQ-8 score was 5.5 (SD 5.0) and mean A1c was 9.93% (SD 1.74). From baseline to 6-months, 17.4% (n=41) achieved a 5-point decrease in PHQ-8; among this subset, the mean PHQ-8 score was 10.49 (SD 4.69), indicative of moderate depression at baseline. Of these 41 participants, 68.3% (n=28) also achieved the threshold A1c improvement at 6-months. After controlling for study arm, education, and age, participants with 5-pt or greater reduction in PHQ-8 score from baseline to 6-months had 2.45 times the odds (CI: 1.16, 5.18) of achieving 0.4% or greater reduction in A1c. Conclusion: Improvements in depressive symptom burden correlate with improvements in diabetes management among women with uncontrolled T2DM. Disclosure P. Gardiner: None. B. M. Cruz: None. A. Bragg: None. M. Winter: None. K. Melo: None. J. M. Howard: None. S. Mitchell: Other Relationship; Self; See Yourself Health LLC, Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK10653)