TY - JOUR
T1 - Depression and glycemic control in hispanic primary care patients with diabetes
AU - Gross, Raz
AU - Olfson, Mark
AU - Gameroff, Marc J.
AU - Carasquillo, Olveen
AU - Shea, Steven
AU - Feder, Adriana
AU - Lantigua, Rafael
AU - Fuentes, Milton
AU - Weissman, Myrna M.
PY - 2005/5
Y1 - 2005/5
N2 - CONTEXT: Maintaining optimal glycemic control is an important goal of therapy in patients with diabetes mellitus. Patients of Hispanic ancestry have been shown to have high rates of diabetes and poor glycemic control (PGC). Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, especially among Hispanics. OBJECTIVE: To assess the association of depression with PGC in Hispanics. DESIGN: Data from a cross-sectional mental health survey in primary care were crosslinked to the hospital's computerized laboratory database. SETTING: Urban general medicine practice at a teaching hospital. PATIENTS: Two hundred and nine patients (mean [standard deviation] age, 57.1 [10.3] years; 68% females) with recent International Classification of Diseases, Ninth Revision (ICD-9) codes for diabetes mellitus, and 1 or more hemoglobin A1c (HbA1c) tests. MAIN OUTCOME MEASURE: Probability of PGC (HbA1c ≥8%). RESULTS: Probability for PGC steadily increased with severity of depression. Thirty-nine (55.7%) of the 70 patients with major depression had HbA 1c ≥8%, compared with 39/92 (42.4%) in the minimal to mild depression group, and 15/47 (31.9%) in the no depression group (P trend=.01: adjusted odds ratio, 3.27; 95% confidence interval, 1.23 to 8.64, for moderate or severe depression vs no depression). Only 29 (41.4%) of the patients with major depression received mental health treatment in the previous year. CONCLUSIONS: In this primary care sample of Hispanic patients with diabetes, we found a significant association between increasing depression severity and PGC. Yet, less than one half of the patients with moderate or severe depression received mental health treatment in the previous year. Improving identification and treatment of depression in this high-risk population might have favorable effects on diabetic outcomes.
AB - CONTEXT: Maintaining optimal glycemic control is an important goal of therapy in patients with diabetes mellitus. Patients of Hispanic ancestry have been shown to have high rates of diabetes and poor glycemic control (PGC). Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, especially among Hispanics. OBJECTIVE: To assess the association of depression with PGC in Hispanics. DESIGN: Data from a cross-sectional mental health survey in primary care were crosslinked to the hospital's computerized laboratory database. SETTING: Urban general medicine practice at a teaching hospital. PATIENTS: Two hundred and nine patients (mean [standard deviation] age, 57.1 [10.3] years; 68% females) with recent International Classification of Diseases, Ninth Revision (ICD-9) codes for diabetes mellitus, and 1 or more hemoglobin A1c (HbA1c) tests. MAIN OUTCOME MEASURE: Probability of PGC (HbA1c ≥8%). RESULTS: Probability for PGC steadily increased with severity of depression. Thirty-nine (55.7%) of the 70 patients with major depression had HbA 1c ≥8%, compared with 39/92 (42.4%) in the minimal to mild depression group, and 15/47 (31.9%) in the no depression group (P trend=.01: adjusted odds ratio, 3.27; 95% confidence interval, 1.23 to 8.64, for moderate or severe depression vs no depression). Only 29 (41.4%) of the patients with major depression received mental health treatment in the previous year. CONCLUSIONS: In this primary care sample of Hispanic patients with diabetes, we found a significant association between increasing depression severity and PGC. Yet, less than one half of the patients with moderate or severe depression received mental health treatment in the previous year. Improving identification and treatment of depression in this high-risk population might have favorable effects on diabetic outcomes.
KW - Depression
KW - Diabetes
KW - Glycemic control
KW - Hispanics
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=22144490901&partnerID=8YFLogxK
U2 - 10.1111/j.1525-1497.2005.30003.x
DO - 10.1111/j.1525-1497.2005.30003.x
M3 - Article
C2 - 15963173
AN - SCOPUS:22144490901
SN - 0884-8734
VL - 20
SP - 460
EP - 466
JO - Journal of General Internal Medicine
JF - Journal of General Internal Medicine
IS - 5
ER -