John D McKellar1, Keith Humphreys1,2, John D Piette3. 1. Veterans Affairs and Stanford University Medical Centers, Palo Alto, California 2. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California 3. Veterans Affairs Center for Practice Management and Outcomes Research, Department of Internal Medicine,zzm321990University of Michigan, and Michigan Diabetes Research and Training Center, Ann Arbor, Michigan
Abstract
PURPOSE: This study evaluated whether diabetes patients with depressive symptoms are more likely than other diabetes patients to report symptoms of glucose dysregulation, and whether this relationship is mediated by the impact of depressive symptoms on patients' adherence to their diabetes self-care regimen. METHODS: Participants were English- and Spanish-speaking adults with type 2 diabetes. Interviewers assessed participants' depressive symptoms and diabetes-related symptoms at baseline. Self-care behaviors and diabetes symptoms were measured at a 1-year follow-up. Structural equation models were used to determine whether depression affected diabetes symptoms by limiting patients' ability to adhere to self-care recommendations. RESULTS: An initial model identified direct effects of baseline depressive symptoms on self-care and diabetes symptoms at follow-up. The relationship between self-care behaviors and physical symptoms of poor glycemic control were assessed using a second model. Results explained the relationship between depressive symptoms at baseline and diabetes symptoms at 1 year. CONCLUSIONS: Depressive symptoms impact subsequent physical symptoms of poor glucose control by influencing patients' ability to adhere to their self-care regimen. More aggressive management of depression among patients with diabetes may improve their physical health as well as their mental health.
PURPOSE: This study evaluated whether diabetespatients with depressive symptoms are more likely than other diabetespatients to report symptoms of glucose dysregulation, and whether this relationship is mediated by the impact of depressive symptoms on patients' adherence to their diabetes self-care regimen. METHODS:Participants were English- and Spanish-speaking adults with type 2 diabetes. Interviewers assessed participants' depressive symptoms and diabetes-related symptoms at baseline. Self-care behaviors and diabetes symptoms were measured at a 1-year follow-up. Structural equation models were used to determine whether depression affected diabetes symptoms by limiting patients' ability to adhere to self-care recommendations. RESULTS: An initial model identified direct effects of baseline depressive symptoms on self-care and diabetes symptoms at follow-up. The relationship between self-care behaviors and physical symptoms of poor glycemic control were assessed using a second model. Results explained the relationship between depressive symptoms at baseline and diabetes symptoms at 1 year. CONCLUSIONS:Depressive symptoms impact subsequent physical symptoms of poor glucose control by influencing patients' ability to adhere to their self-care regimen. More aggressive management of depression among patients with diabetes may improve their physical health as well as their mental health.
Authors: Ian M Kronish; Nina Rieckmann; Ethan A Halm; Daichi Shimbo; David Vorchheimer; Donald C Haas; Karina W Davidson Journal: J Gen Intern Med Date: 2006-08-09 Impact factor: 5.128
Authors: L J Fitten; F Ortiz; L Fairbanks; M Rosenthal; G N Cole; F Nourhashemi; M A Sanchez Journal: J Nutr Health Aging Date: 2008-11 Impact factor: 4.075
Authors: Lisa L Sumlin; Theresa J Garcia; Sharon A Brown; Mary A Winter; Alexandra A García; Adama Brown; Heather E Cuevas Journal: Diabetes Educ Date: 2014-06-17 Impact factor: 2.140
Authors: Martha M Funnell; Tammy L Brown; Belinda P Childs; Linda B Haas; Gwen M Hosey; Brian Jensen; Melinda Maryniuk; Mark Peyrot; John D Piette; Diane Reader; Linda M Siminerio; Katie Weinger; Michael A Weiss Journal: Diabetes Care Date: 2010-01 Impact factor: 19.112