Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen

• Published in: Diabetic medicine 2008-11, Vol.25 (11), p.1324-1329
• Main Authors: Aikens, J. E., Perkins, D. W., Piette, J. D., Lipton, B.
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Blood Glucose - metabolism; Blood Glucose Self-Monitoring - psychology; Blood Glucose Self-Monitoring - standards; depression; Depression - etiology; Depression - metabolism; diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - psychology; diabetes regimen; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Glycated Hemoglobin A - metabolism; Humans; Hypoglycemic Agents - therapeutic use; Insulin - therapeutic use; Male; Medical sciences; Medication Adherence - psychology; Medication Adherence - statistics & numerical data; Middle Aged; Quality of Life; Self Care; Type 2 diabetes mellitus; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Vertebrates: endocrinology
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/j.1464-5491.2008.02590.x

Aims  Although depression has weak associations with several Type 2 diabetes mellitus (DM) outcomes, it is possible that these associations are concentrated within certain patient subgroups that are more vulnerable to their effects. This study tested the hypothesis that depression is related to glycaemic control and diabetes‐related quality of life (DQOL) in patients who are prescribed injected insulin, but not those on oral glucose‐lowering agents alone. Methods  Participants (103 on insulin, 155 on oral glucose‐lowering agents alone) with Type 2 DM were recruited from a large US healthcare system and underwent assessment of glycaemic control (glycated haemoglobin; HbA1c), medication adherence and diabetes self‐care behaviours, DQOL and depression (none, mild, moderate/severe). Results  There was a significant regimen × depression interaction on HbA1c (P = 0.002), such that depression was associated with HbA1c in patients using insulin (β = 0.35, P