Racial and ethnic variation: The association between diabetes and depression

Background: Research indicates that diabetics are at increased risk for depression. Though this co-morbidity has been studied extensively, few studies have explored the variation in this association by race and ethnicity. Racial/ethnic differences may be evident due to subgroup differences in diabetes management and overall risk for depressive disorders.

Methods: This study examined the relationship between self-reported diabetes and lifetime major depressive disorder (MDD) by racial and ethnic status in a nationally representative sample of African Americans (AAs), Afro-Caribbean Blacks (CBs) and Non-Latino Whites (NLWs). 5,899 non-institutionalized adults from the 2001-2003 National Survey of American Life (NSAL) were analyzed. Logistic regression models examined the moderating role of race/ethnicity between diabetes and MDD among AAs, CBs, and NLWs, adjusting for known confounders.

Results: Overall, diabetics were more likely to experience MDD compared to non-diabetics (OR=3.92; CI =1.52, 10.15). Tests for interaction revealed variation by race (p-value<0.02). Diabetic Blacks (AAs and CBs) were 86% less likely (OR=0.14; CI=0.09, 0.24) to report MDD relative to diabetic NLWs. In the analysis of ethnicity, no ethnic differences were observed among diabetic AAs (OR=0.15; CI=0.09, 0.25) and CBs (OR=0.14; CI=0.05, 0.37) when compared to diabetic NLWs.

Conclusions: Findings from this study suggest that the association between diabetes and MDD varies by race, with Black diabetics reporting less MDD than NLW diabetics. This study emphasizes the importance of considering racial and ethnic diversity in understanding the association between diabetes and important sequelae, such as depression.