Prevalence and health status differences in disadvantaged diabetic patients with depression

Recently there has been preliminary research linking depression with diabetes, either as a predictor or an outcome. Much of the research has been conducted on commercial populations, and the direction of effects remains puzzling. This study examined a random sample drawn from community health center diabetes registries in 3 ethnically and racially diverse settings. Patients completed questionnaires on self-reported health, diabetes self-management, and depression. Those enrolled did not differ from those not enrolled on A1c, BP, LDL, BMI, gender, or ethnicity. 27% of patients screened in for depressive symptoms. Diabetic patients with depression compared to those without did not differ significantly on A1c, BMI, BP, or LDL. They did however differ significantly on several self-reported health measures, including more pain, more emotional problems, less energy, poorer general health, and more social and physical limitations on activities. In terms of self-reported diabetic management, patients with depression reported eating fewer fruits and vegetables, and a trend toward eating more high fat meals. The findings suggest a high proportion of diabetic patients in a disadvantaged population have depressive symptoms that are associated with overall physical and social limitations, and at least one area of poor self-management. Physiological health status of diabetics with depression does not seem to be diminished relative to other patients with diabetes, although the quality of life of these patients is clearly poorer. Treatment of the depression should improve the quality of life as well as potentially diabetic self management thus maintaining or improving diabetic outcomes.