Diabetes Care, Vol 23, Issue 1 23-29, Copyright © 2000 by American Diabetes Association

ARTICLES

Depressive symptoms and metabolic control in African-Americans with type 2 diabetes

TL Gary, RM Crum, L Cooper-Patrick, D Ford and FL Brancati
Department of Epidemiology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.

OBJECTIVE: To determine the prevalence of depressive symptoms and the relationship between depressive symptoms and metabolic control. RESEARCH DESIGN AND METHODS: We conducted a cross-sectional study of 183 African-American adults aged 35-75 years with type 2 diabetes who were recruited from two primary care clinics in East Baltimore, Maryland. Depressive symptoms, using the Center for Epidemiological Studies Depression Scale (CES-D), HbA1c, fasting lipid profile, BMI, and blood pressure, were measured on each participant. Diabetes-related health behaviors were assessed by questionnaire. RESULTS: The prevalence of depressive symptoms (CES-D > or =22) was 30%. After adjustment for age, sex, income, social support, and duration of diabetes in linear regression models, there were significant graded relationships between greater depressive symptoms and higher serum levels of cholesterol and triglycerides (P<0.050). Similar, albeit less statistically significant, relationships were found with higher levels of HbA1c (P = 0.104), diastolic blood pressure (P = 0.073), and LDL cholesterol (P = 0.176). Unexpectedly, individuals who reported more depressive symptoms also had higher serum levels of HDL cholesterol (P = 0.047). The associations were not explained by differences in diabetes-related health behaviors. CONCLUSIONS: Depressive symptoms are marginally associated with suboptimal levels of HbA1c, diastolic blood pressure, and LDL cholesterol, and significantly associated with suboptimal levels of total cholesterol and triglyceride levels. Prospective studies are required to determine whether improved identification and management of depressive symptoms would enhance metabolic control in this population.
CiteULike    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				C. V. Igna, J. Julkunen, H. Vanhanen, P. Keskivaara, and M. Verkasalo Depressive Symptoms and Serum Lipid Fractions in Middle-Aged Men: Physiologic and Health Behavior Links Psychosom Med, November 1, 2008; 70(9): 960 - 966. [Abstract] [Full Text] [PDF]

				W. A. Rush, R. R. Whitebird, M. R. Rush, L. I. Solberg, and P. J. O'Connor Depression in Patients with Diabetes: Does It Impact Clinical Goals? J Am Board Fam Med, September 1, 2008; 21(5): 392 - 397. [Abstract] [Full Text] [PDF]

				S. H. Golden, H. B. Lee, P. J. Schreiner, A. D. Roux, A. L. Fitzpatrick, M. Szklo, and C. Lyketsos Depression and Type 2 Diabetes Mellitus: The Multiethnic Study of Atherosclerosis Psychosom Med, July 1, 2007; 69(6): 529 - 536. [Abstract] [Full Text] [PDF]

				M. de Groot, B. Pinkerman, J. Wagner, and E. Hockman Depression treatment and satisfaction in a multicultural sample of type 1 and type 2 diabetic patients. Diabetes Care, March 1, 2006; 29(3): 549 - 553. [Abstract] [Full Text] [PDF]

				K. L. Fisher Assessing Psychosocial Variables: A Tool for Diabetes Educators The Diabetes Educator, January 1, 2006; 32(1): 51 - 58. [Abstract] [Full Text] [PDF]

				E. H. B. Lin, W. Katon, C. Rutter, G. E. Simon, E. J. Ludman, M. Von Korff, B. Young, M. Oliver, P. C. Ciechanowski, L. Kinder, et al. Effects of Enhanced Depression Treatment on Diabetes Self-Care Ann. Fam. Med, January 1, 2006; 4(1): 46 - 53. [Abstract] [Full Text] [PDF]

				S. M. Frayne, J. H. Halanych, D. R. Miller, F. Wang, H. Lin, L. Pogach, E. J. Sharkansky, T. M. Keane, K. M. Skinner, C. S. Rosen, et al. Disparities in Diabetes Care: Impact of Mental Illness Arch Intern Med, December 12, 2005; 165(22): 2631 - 2638. [Abstract] [Full Text] [PDF]

				T. L. Gary, F. Hill-Briggs, M. Batts-Turner, and F. L. Brancati Translational Research Principles of an Effectiveness Trial for Diabetes Care in an Urban African American Population The Diabetes Educator, November 1, 2005; 31(6): 880 - 889. [Abstract] [Full Text] [PDF]

				J. K Kirk, R. A Bell, A. G Bertoni, T. A Arcury, S. A Quandt, D. C Goff Jr., and K M V. Narayan Ethnic Disparities: Control of Glycemia, Blood Pressure, and LDL Cholesterol Among US Adults with Type 2 Diabetes Ann. Pharmacother., September 1, 2005; 39(9): 1489 - 1501. [Abstract] [Full Text] [PDF]

				J. Wenzel, S. W. Utz, R. Steeves, I. Hinton, and R. A. Jones "Plenty of Sickness": Descriptions by African Americans Living in Rural Areas With Type 2 Diabetes The Diabetes Educator, January 1, 2005; 31(1): 98 - 107. [Abstract] [Full Text] [PDF]

				D. T. Lau and D. P. Nau Oral Antihyperglycemic Medication Nonadherence and Subsequent Hospitalization Among Individuals With Type 2 Diabetes Diabetes Care, September 1, 2004; 27(9): 2149 - 2153. [Abstract] [Full Text] [PDF]

				R. D. Goldney, P. J. Phillips, L. J. Fisher, and D. H. Wilson Diabetes, Depression, and Quality of Life: A population study Diabetes Care, May 1, 2004; 27(5): 1066 - 1070. [Abstract] [Full Text] [PDF]

				F. Hll-Briggs, D. C. Cooper, K. Loman, F. L. Brancati, and L. A. Cooper A Qualitative Study of Problem Solving and Diabetes Control in Type 2 Diabetes Self-Management The Diabetes Educator, November 1, 2003; 29(6): 1018 - 1028. [PDF]

				J. Thomas, G. Jones, I. Scarinci, and P. Brantley A Descriptive and Comparative Study of the Prevalence of Depressive and Anxiety Disorders in Low-Income Adults With Type 2 Diabetes and Other Chronic Illnesses Diabetes Care, August 1, 2003; 26(8): 2311 - 2317. [Abstract] [Full Text] [PDF]

				M. R. Niefeld, J. B. Braunstein, A. W. Wu, C. D. Saudek, W. E. Weller, and G. F. Anderson Preventable Hospitalization Among Elderly Medicare Beneficiaries With Type 2 Diabetes Diabetes Care, May 1, 2003; 26(5): 1344 - 1349. [Abstract] [Full Text] [PDF]

				L. E. Egede and D. Zheng Independent Factors Associated With Major Depressive Disorder in a National Sample of Individuals With Diabetes Diabetes Care, January 1, 2003; 26(1): 104 - 111. [Abstract] [Full Text] [PDF]

				L. E. Egede Beliefs and Attitudes of African Americans With Type 2 Diabetes Toward Depression The Diabetes Educator, March 1, 2002; 28(2): 258 - 268. [Abstract] [PDF]

				L. E. Egede, D. Zheng, and K. Simpson Comorbid Depression is Associated With Increased Health Care Use and Expenditures in Individuals With Diabetes Diabetes Care, March 1, 2002; 25(3): 464 - 470. [Abstract] [Full Text] [PDF]

				G. De Berardis, M. Franciosi, M. Belfiglio, B. Di Nardo, S. Greenfield, S. H. Kaplan, F. Pellegrini, M. Sacco, G. Tognoni, M. Valentini, et al. Erectile Dysfunction and Quality of Life in Type 2 Diabetic Patients: A serious problem too often overlooked Diabetes Care, February 1, 2002; 25(2): 284 - 291. [Abstract] [Full Text] [PDF]

				L. Fisher, C. A. Chesla, J. T. Mullan, M. M. Skaff, and R. A. Kanter Contributors to Depression in Latino and European-American Patients With Type 2 Diabetes Diabetes Care, October 1, 2001; 24(10): 1751 - 1757. [Abstract] [Full Text] [PDF]

				G. H. Brody, L. Jack Jr, V. M. Murry, M. Landers-Potts, and L. Liburd Heuristic Model Linking Contextual Processes to Self-Management in African American Adults With Type 2 Diabetes The Diabetes Educator, September 1, 2001; 27(5): 685 - 693. [Abstract] [PDF]

				M. L. Batts, T. L. Gary, K. Huss, M. N. Hill, L. Bone, and F. L. Brancati Patient Priorities and Needs for Diabetes Care Among Urban African American Adults The Diabetes Educator, May 1, 2001; 27(3): 405 - 412. [Abstract] [PDF]