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Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen
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 glyc...
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| Published in: | Diabetic medicine 2008-11, Vol.25 (11), p.1324-1329 |
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| creator | Aikens, J. E. Perkins, D. W. Piette, J. D. Lipton, B. |
| description | 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 |
| doi_str_mv | 10.1111/j.1464-5491.2008.02590.x |
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| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6398157</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>69849865</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5400-7c3d67e03553950f0185dab3a6d24322d1d938b341a300ce988627b3cd67d2a3</originalsourceid><addsrcrecordid>eNqNkc1uEzEUhS0EoqHwCmg2sJvBvzP2AqSqlJQqwIII2Fke-6Y4zE-wZ9rkbfosPBkeEqWww5t75fude490EMoILkh6r9YF4SXPBVekoBjLAlOhcLF9gGbHwUM0wxWnOcMVOUFPYlxjTKhi6jE6IQrzklI2Q_VZjL31ZvB9l9Uw3AJ0mYNNgBinL9O5zPadHUOAbsiWuw38uqOZ8ybBELN-HGzfpubGBJ9KvbufBbj2LXRP0aOVaSI8O9RTtHx3sTy_zBef5u_Pzxa5FRzjvLLMlRVgJgRTAq8wkcKZmpnSUc4odcQpJmvGiWEYW1BSlrSqmU0qRw07RW_2azdj3YKzyW4wjd4E35qw073x-t9J57_r6_5Gl0xJIqq04OVhQeh_jhAH3fpooWlMB_0YdakkV7IUCZR70IY-xgCr4xGC9ZSPXuspBj3FoKd89J989DZJn_9t8l54CCQBLw6AidY0q2A66-ORo1iS5IIn7vWeu_UN7P7bgH774WLqkj7f630cYHvUm_BDlxWrhP76ca6_XX25-kznVC_Yb0jXvXg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>69849865</pqid></control><display><type>article</type><title>Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen</title><source>Wiley</source><creator>Aikens, J. E. ; Perkins, D. W. ; Piette, J. D. ; Lipton, B.</creator><creatorcontrib>Aikens, J. E. ; Perkins, D. W. ; Piette, J. D. ; Lipton, B.</creatorcontrib><description>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 < 0.001) but not in patients using oral agents alone (β = –0.08, P = NS). There was a similar interaction when quality of life was analysed as an outcome (P = 0.002). Neither effect was mediated by regimen adherence.
Conclusions The generally weak association between depression and glycaemic control is concentrated among patients who are prescribed insulin. Similarly, the association between depression and illness quality of life is strongest in patients prescribed insulin. Because this is not attributable to depression‐related adherence problems, psychophysiological mechanisms unique to this group ought to be carefully investigated. Clinicians might be especially vigilant for depression in Type 2 DM patients who use insulin and consider its potential impact upon their illness course.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2008.02590.x</identifier><identifier>PMID: 19046223</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>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</subject><ispartof>Diabetic medicine, 2008-11, Vol.25 (11), p.1324-1329</ispartof><rights>2008 The Authors. Journal compilation © 2008 Diabetes UK</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5400-7c3d67e03553950f0185dab3a6d24322d1d938b341a300ce988627b3cd67d2a3</citedby><cites>FETCH-LOGICAL-c5400-7c3d67e03553950f0185dab3a6d24322d1d938b341a300ce988627b3cd67d2a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20818494$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19046223$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aikens, J. E.</creatorcontrib><creatorcontrib>Perkins, D. W.</creatorcontrib><creatorcontrib>Piette, J. D.</creatorcontrib><creatorcontrib>Lipton, B.</creatorcontrib><title>Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>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 < 0.001) but not in patients using oral agents alone (β = –0.08, P = NS). There was a similar interaction when quality of life was analysed as an outcome (P = 0.002). Neither effect was mediated by regimen adherence.
Conclusions The generally weak association between depression and glycaemic control is concentrated among patients who are prescribed insulin. Similarly, the association between depression and illness quality of life is strongest in patients prescribed insulin. Because this is not attributable to depression‐related adherence problems, psychophysiological mechanisms unique to this group ought to be carefully investigated. Clinicians might be especially vigilant for depression in Type 2 DM patients who use insulin and consider its potential impact upon their illness course.</description><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Glucose Self-Monitoring - psychology</subject><subject>Blood Glucose Self-Monitoring - standards</subject><subject>depression</subject><subject>Depression - etiology</subject><subject>Depression - metabolism</subject><subject>diabetes</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetes Mellitus, Type 2 - psychology</subject><subject>diabetes regimen</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - therapeutic use</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Adherence - psychology</subject><subject>Medication Adherence - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Quality of Life</subject><subject>Self Care</subject><subject>Type 2 diabetes mellitus</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><recordid>eNqNkc1uEzEUhS0EoqHwCmg2sJvBvzP2AqSqlJQqwIII2Fke-6Y4zE-wZ9rkbfosPBkeEqWww5t75fude490EMoILkh6r9YF4SXPBVekoBjLAlOhcLF9gGbHwUM0wxWnOcMVOUFPYlxjTKhi6jE6IQrzklI2Q_VZjL31ZvB9l9Uw3AJ0mYNNgBinL9O5zPadHUOAbsiWuw38uqOZ8ybBELN-HGzfpubGBJ9KvbufBbj2LXRP0aOVaSI8O9RTtHx3sTy_zBef5u_Pzxa5FRzjvLLMlRVgJgRTAq8wkcKZmpnSUc4odcQpJmvGiWEYW1BSlrSqmU0qRw07RW_2azdj3YKzyW4wjd4E35qw073x-t9J57_r6_5Gl0xJIqq04OVhQeh_jhAH3fpooWlMB_0YdakkV7IUCZR70IY-xgCr4xGC9ZSPXuspBj3FoKd89J989DZJn_9t8l54CCQBLw6AidY0q2A66-ORo1iS5IIn7vWeu_UN7P7bgH774WLqkj7f630cYHvUm_BDlxWrhP76ca6_XX25-kznVC_Yb0jXvXg</recordid><startdate>200811</startdate><enddate>200811</enddate><creator>Aikens, J. E.</creator><creator>Perkins, D. W.</creator><creator>Piette, J. D.</creator><creator>Lipton, B.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>200811</creationdate><title>Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen</title><author>Aikens, J. E. ; Perkins, D. W. ; Piette, J. D. ; Lipton, B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5400-7c3d67e03553950f0185dab3a6d24322d1d938b341a300ce988627b3cd67d2a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Glucose Self-Monitoring - psychology</topic><topic>Blood Glucose Self-Monitoring - standards</topic><topic>depression</topic><topic>Depression - etiology</topic><topic>Depression - metabolism</topic><topic>diabetes</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetes Mellitus, Type 2 - psychology</topic><topic>diabetes regimen</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - therapeutic use</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication Adherence - psychology</topic><topic>Medication Adherence - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Quality of Life</topic><topic>Self Care</topic><topic>Type 2 diabetes mellitus</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aikens, J. E.</creatorcontrib><creatorcontrib>Perkins, D. W.</creatorcontrib><creatorcontrib>Piette, J. D.</creatorcontrib><creatorcontrib>Lipton, B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aikens, J. E.</au><au>Perkins, D. W.</au><au>Piette, J. D.</au><au>Lipton, B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2008-11</date><risdate>2008</risdate><volume>25</volume><issue>11</issue><spage>1324</spage><epage>1329</epage><pages>1324-1329</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>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 < 0.001) but not in patients using oral agents alone (β = –0.08, P = NS). There was a similar interaction when quality of life was analysed as an outcome (P = 0.002). Neither effect was mediated by regimen adherence.
Conclusions The generally weak association between depression and glycaemic control is concentrated among patients who are prescribed insulin. Similarly, the association between depression and illness quality of life is strongest in patients prescribed insulin. Because this is not attributable to depression‐related adherence problems, psychophysiological mechanisms unique to this group ought to be carefully investigated. Clinicians might be especially vigilant for depression in Type 2 DM patients who use insulin and consider its potential impact upon their illness course.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>19046223</pmid><doi>10.1111/j.1464-5491.2008.02590.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| 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 |
| title | Association between depression and concurrent Type 2 diabetes outcomes varies by diabetes regimen |
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