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Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究
BACKGROUND: We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self‐care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 dia...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964948/ https://www.ncbi.nlm.nih.gov/pubmed/25349949 http://dx.doi.org/10.1111/1753-0407.12238 |
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author | Zhang, Yuying Ting, Rose ZW Yang, Wenying Jia, Weiping Li, Wenhui Ji, Linong Guo, Xiaohui Kong, Alice PS Wing, Yun‐Kwok Luk, Andrea OY Sartorius, Norman Morisky, Donald E Oldenburg, Brian Weng, Jianping Chan, Juliana CN |
author_facet | Zhang, Yuying Ting, Rose ZW Yang, Wenying Jia, Weiping Li, Wenhui Ji, Linong Guo, Xiaohui Kong, Alice PS Wing, Yun‐Kwok Luk, Andrea OY Sartorius, Norman Morisky, Donald E Oldenburg, Brian Weng, Jianping Chan, Juliana CN |
author_sort | Zhang, Yuying |
collection | PubMed |
description | BACKGROUND: We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self‐care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. METHOD: 2538 patients aged 18–75 years attending hospital‐based clinics in four cities in China underwent detailed clinical‐psychological‐behavioral assessment during a 12‐month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire‐9 (PHQ‐9) score ≥10. Diabetes self‐care and medication adherence were assessed using the Summary of Diabetes Self‐care Activities and the 4‐item Morisky medication adherence scale respectively. RESULTS: In this cross‐sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA (1c) (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA (1c) goal of <7.0% (36.2% vs 45.6%, P = 0.004) than those without depression. They were more likely to report hypoglycemia and to have fewer days of being adherent to their recommended diet, exercise, foot care and medication. In logistic regression, apart from young age, poor education, long disease duration, tobacco use, high body mass index, use of insulin, depression was independently associated with failure to attain HbA (1c) target (Odds Ratio [OR] = 1.56, 95%CI:1.05–2.32, P = 0.028). The association between depression and glycemic control became non‐significant after inclusion of adherence to diet, exercise and medication (OR = 1.48, 95% CI 0.99–2.21, P = 0.058). CONCLUSION: Depression in type 2 diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence. |
format | Online Article Text |
id | pubmed-4964948 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-49649482016-08-11 Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 Zhang, Yuying Ting, Rose ZW Yang, Wenying Jia, Weiping Li, Wenhui Ji, Linong Guo, Xiaohui Kong, Alice PS Wing, Yun‐Kwok Luk, Andrea OY Sartorius, Norman Morisky, Donald E Oldenburg, Brian Weng, Jianping Chan, Juliana CN J Diabetes Original Articles BACKGROUND: We hypothesize that depression in type 2 diabetes might be associated with poor glycemic control, in part due to suboptimal self‐care. We tested this hypothesis by examining the associations of depression with clinical and laboratory findings in a multicenter survey of Chinese type 2 diabetic patients. METHOD: 2538 patients aged 18–75 years attending hospital‐based clinics in four cities in China underwent detailed clinical‐psychological‐behavioral assessment during a 12‐month period between 2011 and 2012. Depression was diagnosed if Patient Health Questionnaire‐9 (PHQ‐9) score ≥10. Diabetes self‐care and medication adherence were assessed using the Summary of Diabetes Self‐care Activities and the 4‐item Morisky medication adherence scale respectively. RESULTS: In this cross‐sectional study (mean age: 56.4 ± 10.5[SD] years, 53% men), 6.1% (n = 155) had depression. After controlling for study sites, patients with depression had higher HbA (1c) (7.9 ± 2.0 vs. 7.7 ± 2.0%, P = 0.008) and were less likely to achieve HbA (1c) goal of <7.0% (36.2% vs 45.6%, P = 0.004) than those without depression. They were more likely to report hypoglycemia and to have fewer days of being adherent to their recommended diet, exercise, foot care and medication. In logistic regression, apart from young age, poor education, long disease duration, tobacco use, high body mass index, use of insulin, depression was independently associated with failure to attain HbA (1c) target (Odds Ratio [OR] = 1.56, 95%CI:1.05–2.32, P = 0.028). The association between depression and glycemic control became non‐significant after inclusion of adherence to diet, exercise and medication (OR = 1.48, 95% CI 0.99–2.21, P = 0.058). CONCLUSION: Depression in type 2 diabetes was closely associated with hyperglycemia and hypoglycemia, which might be partly mediated through poor treatment adherence. John Wiley and Sons Inc. 2015-02-19 2015-11 /pmc/articles/PMC4964948/ /pubmed/25349949 http://dx.doi.org/10.1111/1753-0407.12238 Text en © 2014 The Authors. Ruijin Hospital, Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd This is an open access article under the terms of the Creative Commons Attribution (http://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Zhang, Yuying Ting, Rose ZW Yang, Wenying Jia, Weiping Li, Wenhui Ji, Linong Guo, Xiaohui Kong, Alice PS Wing, Yun‐Kwok Luk, Andrea OY Sartorius, Norman Morisky, Donald E Oldenburg, Brian Weng, Jianping Chan, Juliana CN Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title | Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title_full | Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title_fullStr | Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title_full_unstemmed | Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title_short | Depression in Chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
title_sort | depression in chinese patients with type 2 diabetes: associations with hyperglycemia, hypoglycemia, and poor treatment adherence: 中国人2型糖尿病抑郁情况及其与高血糖、低血糖及治疗依从性关系的研究 |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4964948/ https://www.ncbi.nlm.nih.gov/pubmed/25349949 http://dx.doi.org/10.1111/1753-0407.12238 |
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