|Title||The role of health behaviors in mediating the relationship between depressive symptoms and glycemic control in type 2 diabetes: a structural equation modeling approach.|
|Publication Type||Journal Article|
|Year of Publication||2010|
|Authors||Chiu, C-J, Wray, LA, Beverly, EA, Dominic, OG|
|Journal||Social Psychiatry and Psychiatric Epidemiology|
|Keywords||Adult, 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|
OBJECTIVES: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
|Endnote Keywords|| |
diabetes/Depressive Symptoms/Health care management
|Endnote ID|| |
|PubMed Central ID||PMC2804782|
|Grant List||L60 MD003296 / MD / NIMHD NIH HHS / United States |
L60 MD003296-01 / MD / NIMHD NIH HHS / United States
DK078894 / DK / NIDDK NIH HHS / United States