Differential associations between depressive symptoms and glycaemic control in outpatients with diabetes. Issue 3 (20th February 2013)

• Record Type: Journal Article
• Authors: Bot, M.; Pouwer, F.; de, P.; Tack, C. J.; Geelhoed‐Duijvestijn, P. H. L. M.; Snoek, F. J.
• Is Part Of: Diabetic medicine. Volume 30:Issue 3(2013:Mar.)
• Page Start: e115
• Page End: e122
• Publication Date: 2013-02-20
• Subjects: Diabetes -- Periodicals; 616.462
• DOI: 10.1111/dme.12082
• Languages: English
• ISSNs: 0742-3071

Abstract

<abstract abstract-type="main" id="dme12082-abs-0001"> <title>Abstract</title> <sec id="dme12082-sec-0001" sec-type="section"> <title>Aims</title> <p>Depression is common in people with diabetes, and related to higher HbA<sub>1c</sub> levels. Depression, however, is a heterogeneous construct that involves a variety of symptoms. As little is known about the associations of individual depressive symptoms with HbA<sub>1c</sub>, we explored these associations in outpatients with diabetes.</p> </sec> <sec id="dme12082-sec-0002" sec-type="section"> <title>Methods</title> <p>The study was conducted in three tertiary diabetes clinics in the Netherlands. At baseline, the presence of the nine depressive symptoms that are listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition was assessed with the nine‐item Patient Health Questionnaire (PHQ‐9). At baseline and after a 1‐year follow‐up, HbA<sub>1c</sub> was derived from the medical charts.</p> </sec> <sec id="dme12082-sec-0003" sec-type="section"> <title>Results</title> <p>A total of 288 out of 646 subjects with diabetes (45%) reported one or more depressive symptom(s). Depressed mood (β = 0.11, <italic>P</italic> = 0.005), sleeping difficulties (β = 0.16, <italic>P </italic>< 0.001), appetite problems (β = 0.15, <italic>P </italic>< 0.001) and suicidal ideation (β = 0.14, <italic>P </italic>= 0.001) were significantly related to higher baseline HbA<sub>1c</sub> values. Furthermore, depressed mood (β = 0.09, <italic>P </italic>= 0.03) sleeping difficulties (β = 0.12, <italic>P </italic>= 0.004), appetite problems (β = 0.11, <italic>P </italic>= 0.01) and psychomotor agitation/retardation (β = 0.09, <italic>P </italic>= 0.04) were significantly related to higher HbA<sub>1c</sub> values at 1‐year follow‐up. Associations were more pronounced in Type 1 diabetes than in Type 2 diabetes. None of the depressive symptoms were related to change in HbA<sub>1c</sub> over time, except suicidal ideation.</p> </sec> <sec id="dme12082-sec-0004" sec-type="section"> <title>Conclusion</title> <p>In people with diabetes, several individual depressive symptoms were related to higher HbA<sub>1c</sub> levels. These associations persisted over time. More research is needed to investigate potential mechanistic pathways.</p> </sec> </abstract>