In a study of more than 200 Hispanics with diabetes, researchers at Columbia University's Mailman School of Public Health and College of Physicians and Surgeons found a significant association between depression severity and poor glycemic control (PGC). The findings also confirm that less than one-half of the diabetes patients with moderate or severe depression received mental health treatment in the previous year.
"We found a steady increase in the probability of PGC with advancing categories of depression severity," according to Raz Gross, MD, MPH assistant professor of Epidemiology and Psychiatry at Columbia University's Mailman School of Public Health and College of Physicians and Surgeons and principal author of the study. "This held especially true among patients with moderate-severe depression, where likelihood for PGC was more than three-fold higher compared to patients without depression." No association was found between depression and PGC among the non-Hispanic diabetes patients.
According to Dr. Gross, there is ample evidence that among the population, in general, depressive disorders are more prevalent among adults with diabetes. However, the relationship between depression and glycemic control in patients with diabetes is less obvious. Hispanics have high rates of diabetes and are more likely to have poor glycemic control. Diabetes ranks fifth among the leading causes of death in people of Hispanic origin. Earlier research has indicated that Hispanic patients are usually less likely to have regular sources of medical care, to undergo screening, to use preventive services, to be referred to a specialist, or to receive appropriate treatment.
Says Dr. Gross, "There are important clinical and public health implications to our finding. As rates of diabetes, especially among Hispanics, continue to increase, it is important for clinicians caring for patients with diabetes to be aware of the association between depression and PGC. Our findings suggest that identification and adequate treatment of depression in this understudied, high-risk population of Hispanic primary care patients might have favorable effects on diabetic outcomes."