Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence

• Published in: Journal of diabetes 2015-11, Vol.7 (6), p.800-808
• Main Authors: Zhang, Yuying, Ting, Rose ZW, Yang, Wenying, Jia, Weiping, Li, Wenhui, Ji, Linong, Guo, Xiaohui, Kong, Alice PS, Wing, Yun-Kwok, Luk, Andrea OY, Sartorius, Norman, Morisky, Donald E, Oldenburg, Brian, Weng, Jianping, Chan, Juliana CN
• Format: Article
• Language: English
• Subjects: Aged; Asian Continental Ancestry Group - psychology; Biomarkers - blood; Blood Glucose - drug effects; Blood Glucose - metabolism; Chi-Square Distribution; China - epidemiology; Cross-Sectional Studies; depression; Depression - diagnosis; Depression - ethnology; Depression - psychology; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - ethnology; Diabetes Mellitus, Type 2 - psychology; Female; Health Care Surveys; Humans; hyperglycemia; Hyperglycemia - blood; Hyperglycemia - diagnosis; Hyperglycemia - drug therapy; Hyperglycemia - psychology; hypoglycemia; Hypoglycemia - blood; Hypoglycemia - chemically induced; Hypoglycemia - diagnosis; Hypoglycemia - ethnology; Hypoglycemia - psychology; Hypoglycemic Agents - adverse effects; Logistic Models; Male; Medication Adherence - ethnology; Medication Adherence - psychology; Middle Aged; Odds Ratio; Risk Factors; Self Care - psychology; Surveys and Questionnaires; treatment adherence; Treatment Outcome; type 2 diabetes; 关键词：抑郁、高血糖、低血糖、治疗依从性、2型糖尿病
• ISSN: 1753-0393; 1753-0407
• DOI: 10.1111/1753-0407.12238

Background We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self‐care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. Method 2538 patients aged 18–75 years attending hospital‐based clinics in four cities in China underwent detailed clinical‐psychological‐behavioral assessment during a 12‐month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire‐9 (PHQ‐9) score ≥10. Diabetes self‐care and medication adherence were assessed using the Summary of Diabetes Self‐care Activities and the 4‐item Morisky medication adherence scale respectively. Results In this cross‐sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA1c (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA1c goal of