Korean Diabetes J.  2009 Oct;33(5):432-438. 10.4093/kdj.2009.33.5.432.

Depression and Self-care Behavior in Patients with Diabetes Mellitus

• Kim SY
• Lee JH
• Kim HN
• Kim DK
• Na Y
• Kim GS
• Kim MK
• Baek KH
• Kang MI
• Lee KW
• Song KH

• KMID: 2231150
• DOI: http://doi.org/10.4093/kdj.2009.33.5.432

Abstract

BACKGROUND
Depression is known to be a risk factor for type 2 diabetes mellitus. Conversely, diabetes is also a risk factor for depression, and patients with diabetes have nearly twice the risk of comorbid depression as the general population. Depression in patients with diabetes may cause poor clinical outcomes through lower adherence to self-care activities such as exercise, diet control, and glucose monitoring. Furthermore, diabetic patients with depression are more likely to suffer from microvascular or macrovascular complications. We explored the prevalence of major depressive disorder in Korean diabetic patients and its impact on self-care activities and glucose control.
METHODS
We surveyed depressive symptoms and self-care activities in 191 type 2 diabetic patients from the outpatient clinic of the St. Mary's hospital. Two questionnaires were used for assessment, the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS) and the Summary of Diabetes Self-Care Activities (SDSCA).
RESULTS
Of the 191 respondents who completed questionnaires, 39 (20.4%) patients were categorized as having major depressive disorder. Among the depressed patients, only six (15.3%) had been previously evaluated and managed for their psychiatric problems. The incidence of depression was significantly higher in female diabetic patients compared to patients without depression (74.4% vs. 45.4%, P<0.001). Patients with depression showed significantly poorer diet control (18.5 vs. 15.9, P = 0.046) and less glucose monitoring (4.1 vs. 2.7, P = 0.047). However, there were no differences in exercise, foot care, or smoking status between the two groups. Additionally, metabolic parameters such as HbA1C and lipid profile were not significantly different between the two groups.
CONCLUSION
Many diabetic patients are suffering from depression and exhibit poorer self-care activities than patients without depression. Identifying and managing depressed diabetic patients may help improve their self-care activities.

Keyword

Diabetes Complications; Diabetes; Depression; Self-care

MeSH Terms

Ambulatory Care Facilities
Surveys and Questionnaires
Depression
Depressive Disorder, Major
Diabetes Complications
Diabetes Mellitus
Diabetes Mellitus, Type 2
Diet
Female
Foot
Glucose
Humans
Incidence
Mass Screening
Prevalence
Risk Factors
Self Care
Smoke
Smoking
Stress, Psychological
Glucose
Smoke

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