The Effects of Depressive Symptoms to Metabolic and Glycemic Control among Type 2 Diabetes Patients

ABSTRACT

BACKGROUND: Depression is common among type 2 diabetic patients. To determine the relationship between depressive symptoms and metabolic control, we evaluated the risk factors that are related to metabolic control in diabetic patients. METHODS: This study was performed among 356 type 2 diabetic outpatients, who visited the Department of Family Medicine and Endocrinology, Samsung Medical Center, from November 2003 to January 2004. The data were collected through questionnaire about sociodemographic features diabetes-related factors and health behaviors. Beck Depression Inventory (BDI) was administered to measure depressive symptoms. The medical records were reviewed to confirm metabolic controls including HbA1c, lipids, blood pressure, body mass index (BMI), past medical history, and prescriptions. RESULTS: The prevalence of depressive symptoms (BDI> or =11) was 35.4%, including severe symptoms (BDI> or =21) 6.8%. There were significant graded relationships between greater depressive symptoms and higher serum level of HbA1c (P=0.000) and LDL-cholesterol (P=0.046). In binary logistic regression analysis, low level of exercise (OR=1.97; 95% CI=1.18~3.28), lack of exercise (OR= 2.94; 95% CI=1.28~6.77), poor LDL-cholesterol control (OR=1.94; 95% CI=1.19~3.18), and depressed group (OR=2.20; 95% CI=1.35~3.60) were significantly associated with poor glycemic control. CONCLUSION: There is a significant association between depressive symptoms and glycemic control of type 2 diabetes. Therefore, family physicians who provide continuous and comprehensive primary care should be more concerned for depressive symptoms in type 2 diabetes patients.