Correlates of depression among people with diabetes: The Translating Research Into Action for Diabetes (TRIAD) study

Abstract

Aim The broad objective of this study was to examine multiple dimensions of depression in a large, diverse population of adults with diabetes. Specific aims were to measure the association of depression with: (1) patient characteristics; (2) outcomes; and (3) diabetes-related quality of care. Methods Cross-sectional analyses were performed using survey and chart data from the Translating Research Into Action for Diabetes (TRIAD) study, including 8790 adults with diabetes, enrolled in 10 managed care health plans in 7 states. Depression was measured using the Patient Health Questionnaire (PHQ-8). Patient characteristics, outcomes and quality of care were measured using validated survey items and chart data. Results Nearly 18% of patients had major depression, with prevalence 2-3 times higher among patients with low socioeconomic status. Pain and limited mobility were strongly associated with depression, controlling for other patient characteristics. Depression was associated with slightly worse glycemic control, but not other intermediate clinical outcomes. Depressed patients received slightly fewer recommended diabetes-related processes of care. Conclusions In a large, diverse cohort of patients with diabetes, depression was most prevalent among patients with low socioeconomic status and those with pain, and was associated with slightly worse glycemic control and quality of care.

Painful Diabetic Neuropathy is More than Pain Alone: Examining the Role of Anxiety and Depression as Mediators and Complicators

“…Of concern, depression was associated with a number of diabetic complications, including retinopathy, nephropathy, macrovascular complications, sexual dysfunction, and neuropathy [10]. Studies conducted in the past decade have replicated these findings of high prevalence of depression in patients with diabetes [9,11,12]. Moreover, the complex relationship between diabetes and anxiety/depression is not just observed here in the United States, but also in other parts of the world [13].…”

“…The presence of anxiety and/or depression leads to poorer outcomes for micro-and macrovascular complications of diabetes, with pain and physical mobility being added complications [11]. An additional complication of having depression and/or anxiety is that diabetic patients with these comorbidities are less compliant with self-monitoring, keep fewer appointments with primary care clinicians, exercise less, and have lower dietary adherence [16,17].…”

Low Socioeconomic Status is Associated with Increased Risk for Hypoglycemia in Diabetes Patients: The Diabetes Study of Northern California (DISTANCE)

“…Since food insecurity is known to be associated with both low SES and hypoglycemia, 29, 30 it may be an important avenue for future work, especially as a significant association between SES and hypoglycemia remained unexplained by the inclusion of health literacy and difficulty filling prescriptions. In addition, factors that are more common in low SES patients, such as more severe diabetes 5, 31 , decreased social support 32-35 , and higher rates of depression 12, 36 may explain some of the association between lower income/educational attainment and hypoglycemia. The latter two may be particularly important for explaining increased hypoglycemia at relatively higher income levels, where material deprivation or cost-related medication underuse may be less common.…”

Metabolic control and depression in type 1 diabetes mellitus

“…Результаты оценки гликемического контроля в зави-симости от наличия ДП при использовании стандартных подходов, свидетельствующие о негативном влиянии ДП на компенсацию углеводного обмена, аналогичны резуль-татам ряда исследований [10][11][12][13][14]. Однако в вышеупомяну-тых работах не проводилось различий между пациентами с 1 и 2 типом СД.…”