Endocrine Abstracts

Background: Depressive symptoms (DS) and diabetes-related distress (DD) are common comorbidities in diabetic patients adversely affecting diabetes self-management and patients’ well-being.

Aim: To examine associations between DS and DD with glycaemic control, quality of life and diabetes self-management.

Materials and methods: Depressive symptoms, DD, quality of life, diabetes self-management and metabolic indicators were assessed in 148 participants included in a Day Hospital educational programme (aged 42 ± 15 years, 57% female, 78% T1 diabetes) at baseline and after a one-year follow-up. Associations between these variables were analysed in patients with: 1. depressive symptoms (n = 26), 2. diabetes-related distress (n = 14), 3. both symptoms (n = 19), and 4. without symptoms (n = 89) by using Kruskal-Wallis test. Prognostic value of the included variables for one-year metabolic outcomes was determined by regression analysis.

Results: The groups differed with respect to health-related quality of life and diabetes self-management: examinees without symptoms reported better quality of life (Kruskal-Wallis H = 10,4 P = 0,02; H = 52,9 P < 0.01) and better adherence to diet (H = 8,9 P = 0,03), self-monitoring blood glucose (H = 7,9 P = 0,05) and exercise (H = 12,3 P < 0,01). Metabolic indicators did not differ between the groups. Examinees without emotional symptoms improved their HbA1c (7.6% ± 1.2 vs 7.3% ± 1.1 P = 0,04) during a follow-up period while other groups did not. Diabetes-related distress was shown to be a long-term predictor of metabolic control (stand. ß = .228 P = .025), while quality of life could be predicted by DS (stand.ß = −.422 P < .0001) and DD (stand.ß = −.329P < .0001; stand.ß = −.459 P < .0001).

Conclusion: Depressive symptoms and DD are longitudinally associated with patients’ quality of life, diabetes self-management and diabetes control. Both symptoms should be recognized in order to establish an appropriate clinical approach.

Keywords: diabetes, depressive symptoms, diabetic-related distress, glycemic control, self-management of diabetes, quality of life.