Depression and glycemic control in hispanic primary care patients with diabetes

Raz Gross, Mark Olfson, Marc J. Gameroff, Olveen Carasquillo, Steven Shea, Adriana Feder, Rafael Lantigua, Milton Fuentes, Myrna M. Weissman

Research output: Contribution to journalArticleResearchpeer-review

72 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)460-466
Number of pages7
JournalJournal of General Internal Medicine
Volume20
Issue number5
DOIs
StatePublished - 1 May 2005

Fingerprint

Hispanic Americans
Primary Health Care
Depression
International Classification of Diseases
Mental Health
Diabetes Mellitus
Hemoglobins
Hospital Laboratories
Therapeutics
Health Surveys
Teaching Hospitals
General Practice
Odds Ratio
Medicine
Databases
Confidence Intervals

Keywords

  • Depression
  • Diabetes
  • Glycemic control
  • Hispanics
  • Primary care

Cite this

Gross, R., Olfson, M., Gameroff, M. J., Carasquillo, O., Shea, S., Feder, A., ... Weissman, M. M. (2005). Depression and glycemic control in hispanic primary care patients with diabetes. Journal of General Internal Medicine, 20(5), 460-466. https://doi.org/10.1111/j.1525-1497.2005.30003.x
Gross, Raz ; Olfson, Mark ; Gameroff, Marc J. ; Carasquillo, Olveen ; Shea, Steven ; Feder, Adriana ; Lantigua, Rafael ; Fuentes, Milton ; Weissman, Myrna M. / Depression and glycemic control in hispanic primary care patients with diabetes. In: Journal of General Internal Medicine. 2005 ; Vol. 20, No. 5. pp. 460-466.
@article{8cb3ffa3af4644bbb42030c0608c10db,
title = "Depression and glycemic control in hispanic primary care patients with diabetes",
abstract = "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.",
keywords = "Depression, Diabetes, Glycemic control, Hispanics, Primary care",
author = "Raz Gross and Mark Olfson and Gameroff, {Marc J.} and Olveen Carasquillo and Steven Shea and Adriana Feder and Rafael Lantigua and Milton Fuentes and Weissman, {Myrna M.}",
year = "2005",
month = "5",
day = "1",
doi = "10.1111/j.1525-1497.2005.30003.x",
language = "English",
volume = "20",
pages = "460--466",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer Nature",
number = "5",

}

Gross, R, Olfson, M, Gameroff, MJ, Carasquillo, O, Shea, S, Feder, A, Lantigua, R, Fuentes, M & Weissman, MM 2005, 'Depression and glycemic control in hispanic primary care patients with diabetes', Journal of General Internal Medicine, vol. 20, no. 5, pp. 460-466. https://doi.org/10.1111/j.1525-1497.2005.30003.x

Depression and glycemic control in hispanic primary care patients with diabetes. / Gross, Raz; Olfson, Mark; Gameroff, Marc J.; Carasquillo, Olveen; Shea, Steven; Feder, Adriana; Lantigua, Rafael; Fuentes, Milton; Weissman, Myrna M.

In: Journal of General Internal Medicine, Vol. 20, No. 5, 01.05.2005, p. 460-466.

Research output: Contribution to journalArticleResearchpeer-review

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 - 2005/5/1

Y1 - 2005/5/1

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

VL - 20

SP - 460

EP - 466

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 5

ER -