Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care

Objective: Our study aimed to determine whether depressive symptoms are associated with poor self-care behaviors among patients with type 2 diabetes. Methods: Study subjects were 168 patients with diabetes, aged >30 years, who had a diabetes history of 1-15 years. Using a self-reported questionnaire, we evaluated diabetes self-care behaviors and depressive symptoms. Self-care behaviors were evaluated in five categories: medication taking, self-monitoring of blood glucose (SMBG), diet, exercise, and participation in patient education programs. Depressive symptoms were evaluated using the Centers for Epidemiologic Studies-Depression (CES-D) scales. Multiple logistic regression analyses were used to determine the association between self-care behaviors and depressive symptoms. Results: Higher depressive-symptom scores were associated with poor self-care behaviors, significantly with poor participation in education programs (odds ratio OR = 1.21, 95% confidence interval CI = 1.06-1.38) and poor diet (OR = 1.11, 95% CI = 1.01-1.22), and marginally with poor medication taking (OR = 1.14, 95% CI = 1.00-1.31). Depressive symptoms were not significantly associated with either SMBG or exercise. Conclusions: These data suggest that the evaluation and control of depressive symptoms among diabetic patients would improve their adherence to self-care behaviors. (C) 2004 Elsevier Inc. All rights reserved.