Abstract P133: Psychological Distress, Diabetes Self-Management, and Cardiovascular Disease Risk Factors Among a Primary Care Sample of Spanish Speaking Hispanic/Latinos With Type 2 Diabetes

Abstract

Aims: The aim of this study was to examine the relationships between psychological distress (anxiety, depression, and diabetes-distress), diabetes self-management (DSM) behaviors, and cardiovascular disease (CVD) risk factors/diabetes control among adult primary care, non-insulin using Hispanic/Latino patients with type 2 diabetes. Methods: This abstract presents a cross-sectional analysis of the baseline data from an ongoing clinical trial of 456 Hispanic/Latino participants with type 2 diabetes (mean age 55.2 ± 9.8 years; 63.7% female) at a federally qualified health center in San Diego. General linear models were used to examine associations between anxiety, depression, and diabetes-distress (assessed using the Patient Health Questionnaire-8 [PHQ-8], the Generalized Anxiety Disorder 7-item scale [GAD-7], and the Diabetes Distress scale-2, respectively), DSM behaviors (assessed using the Summary of Diabetes Self-Care Activities Assessment [SDSCA]), and markers of CVD risk (glycated hemoglobin [HbA1c], body mass index, systolic and diastolic blood pressure, and HDL and LDL cholesterol), controlling for the demographics variables of age, sex, and education. Results: Moderate depression and anxiety symptoms (defined as a PHQ-8 and GAD-7 cutoff of 10) were present in the study sample at rates of 21.5% and 15.4%, respectively. Poorly controlled diabetes (HbA1c > 8.0%) was present in 40.6% of the sample. After controlling for covariates, all three indicators of psychological distress showed significant, negative associations with SDSCA (DSM) scores (p < 0.01). Depression and anxiety symptoms were positively associated with LDL cholesterol (p = 0.020 and p = 0.022, respectively). No other associations among psychological distress and CVD risk factors were significant. DSM behaviors were not associated with any CVD risk factors. Conclusions: Depression and anxiety affect a large percentage of the Hispanic/Latino population. As greater depression and anxiety symptoms were associated with worsened diabetes self-management behaviors, for example diet and glucose monitoring, there may be implications for DSM and other CVD risk factors. Psychosocial dimensions of health are important to consider when providing care and promoting self-management behaviors in this population, as promoted by frameworks such as the integrative care model.