Abstract
Aims and Objectives: Depression is common among patients with chronic medical illnesses. The impact of depressive symptoms in patients with type 2 diabetes on self-care and glycosylated hemoglobin (HbA1c) was explored. Background: Depression is known to decrease compliance with most medical regimens. This study investigated depression’s effects on different aspects of compliance with a diabetic regimen. Design: Cross-sectional, correlational, quantitative study. Methods: A cross-sectional study was conducted using data from 126 patients with type 2 diabetes from a diabetes education class. Participants completed depression and self-care inventories. Regression analyses were performed to determine the impact of depressive symptoms on the dependent variables of compliance to diabetes self-care and HbA1c levels. Results: Levels of depression were significantly and inversely correlated with 1) total self-care scores, accounting for 5.1% of the variance, 2) compliance with glucose self-monitoring accounting for 3.4% of the variance, and 3) compliance with diet accounting for 9.3% of the variance. Levels of depression were not significantly related to HbA1c. Conclusions: Depressive symptoms are associated with poorer total self-care, poorer glucose self-monitoring, and poorer dietary compliance in type 2 diabetes patients. Depression scores help explain variations in patients’ performance with aspects of compliance to diabetes management. Relevance to clinical practice: Administering a personality questionnaire, perhaps on the initial visit could enable the clinical to know which aspects of diabetes self-care are affected by depression, which would enable the clinician to more closely monitor melancholic patients in the effort to improve glycemic control and medical outcomes.
Highlights
The risk of depression in patients with diabetes is approximately double compared with those without diabetes [1] [2]
Significant correlations were found between Depression and Total Summary of Diabetes Self-Care Activities (SDSCA) scores and depression and Total General Diet score
The full model accounted for 20% of the variance in Total SDSCA scores, with depression accounting for 5.1% of the variance
Summary
The risk of depression in patients with diabetes is approximately double compared with those without diabetes [1] [2]. Prevalence of depression among patients with diabetes ranges from 8% to 15%, compared with an estimate of only 3% to 4% in the general population [1] [3] [4]. 20% of diabetes patients suffer clinically significant symptoms [5]. Type 2 diabetes patients with comorbid depression have a significant increase in mortality [6] [7]. Depression increases the risk of poor glycemic control and diabetes complications [8] [9]
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