The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.

TitleThe role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.
Publication TypeJournal Article
Year of Publication2010
AuthorsChiu, C-J, Wray, LA, Beverly, EA, Dominic, OG
JournalSoc Psychiatry Psychiatr Epidemiol
Volume45
Issue1
Pagination67-76
Date Published2010 Jan
ISSN Number1433-9285
Call Numbernewepubs20100129_Chiu-Wray.pdf
KeywordsAdult, Aged, Blood Glucose, Body Weight, Comorbidity, depression, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glycated Hemoglobin A, Glycemic Index, Health Behavior, Health Surveys, Humans, Life Style, Longitudinal Studies, Male, Middle Aged, Models, Statistical, Self Care, Smoking, United States
Abstract

<p><b>OBJECTIVES: </b>We investigated the longitudinal association between depressive symptoms and glycemic control (HbA1c) in adults with type 2 diabetes, and the extent to which that association was explained by health behaviors.</p><p><b>METHODS: </b>This study assessed data on 998 adults (aged 51 and above) with type 2 diabetes in the US nationally representative Health and Retirement Study and its diabetes-specific mail survey. Participants' depressive symptoms and baseline health behaviors (exercise, body weight control, and smoking status) were collected in 1998. Follow-up health behaviors and the glycemic control outcome were measured at a 2- and 5-year intervals, respectively.</p><p><b>RESULTS: </b>Nearly one in four of participants (23%) reported moderate or high levels of depressive symptoms at baseline (CES-D score >or=3). Adults with higher levels of depressive symptoms at baseline showed lower scores on baseline and follow-up health behaviors as well as higher HbA1c levels at a 5-year follow-up. Structural equation models (SEM) reveal that health behaviors accounted for 13% of the link between depressive symptoms and glycemic control.</p><p><b>CONCLUSIONS: </b>The long-term relationship between depressive symptoms and glycemic control was supported in the present study. Health behaviors, including exercise, body weight control, and smoking status, explained a sizable amount of the association between depressive symptoms and glycemic control. More comprehensive diabetes self-care behaviors should be examined with available data. Other competing explicators for the link, such as endocrinological process and antidepressant effects, also warrant further examination.</p>

Notes

PMID: 19343264

DOI10.1007/s00127-009-0043-3
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/19343264?dopt=Abstract

Endnote Keywords

diabetes/Depressive Symptoms/Health care management

Endnote ID

21750

Alternate JournalSoc Psychiatry Psychiatr Epidemiol
Citation Key7437
PubMed ID19343264
PubMed Central IDPMC2804782
Grant ListL60 MD003296 / MD / NIMHD NIH HHS / United States
L60 MD003296-01 / MD / NIMHD NIH HHS / United States
DK078894 / DK / NIDDK NIH HHS / United States