The effects of depression on metabolic control and quality of life in indigent patients with type 2 diabetes.

Egede LE, Ellis C. The effects of depression on metabolic control and quality of life in indigent patients with type 2 diabetes. Diabetes Technology & Therapeutics. 2010 Apr 1; 12(4):257-62.

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Abstract:

BACKGROUND: The objective of this study was to assess differences in metabolic control and health-related quality of life (QOL) among depressed and nondepressed adults in an indigent population with type 2 diabetes. RESEARCH DESIGN AND METHODS: Subjects completed validated surveys to assess depression and QOL. Depression was assessed with the Center for Epidemiological Studies-Depression Scale and defined as a score of > or = 16. Metabolic control (hemoglobin A1C, total cholesterol, low-density lipoprotein [LDL] cholesterol, and high-density lipoprotein [HDL] cholesterol) measures were abstracted from medical records. We compared demographic characteristics, metabolic control, and QOL by depression status. Ordinary least squares regression was used to assess differences in QOL scores and metabolic control levels by depression status adjusting for covariates. RESULTS: In the study sample (n = 201), approximately 20% (n = 40) were depressed. In unadjusted analyses, subjects with depression had significantly lower SF-12 physical component summary (PCS) scores (30.4 +/- 7.3 vs. 39.6 +/- 11.8, P < 0.001) and mental component summary (MCS) scores (32.8 +/- 10.5 vs. 48.9 +/- 9.2, P < or = 0.001) and significantly higher total cholesterol (209.3 +/- 72.1 vs. 186.6 +/- 50.9, P = 0.024) compared to those without depression. No significant differences were observed by depression status in hemoglobin A1C, LDL cholesterol, and HDL cholesterol. After adjustment for relevant covariates, depressed individuals continued to have lower SF-12 PCS (36.1 vs. 39.0, P < or = 0.001) and MCS (41.6 vs. 46.8, P < or = 0.001) scores, but the difference in total cholesterol levels was no longer significant. CONCLUSIONS: In an indigent sample with type 2 diabetes, depression is significantly associated with decreased physical and mental components of QOL. This finding further reinforces the importance of addressing depression in all populations with type 2 diabetes.