Depressive symptoms and metabolic control in African-Americans with type 2diabetes

OBJECTIVE- To determine the prevalence of depressive symptoms and the relat ionship between depressive symptoms and metabolic control. RESEARCH DESIGN AND METHODS- We conducted a cross-sectional study of 183 Af rican-American adults aged 35-75 years with type 2 diabetes who were recrui ted from two primary care clinics in East Baltimore, Maryland. Depressive s ymptoms, using the Center for Epidemiological Studies Depression Scale (CES -D), HbA(1c), fasting lipid profile, BMI, and blood pressure, were measured on each participant. Diabetes-related health behaviors were assessed by qu estionnaire. RESULTS- The prevalence of depressive symptoms (CES-D greater than or equal to 22) was 30%. After adjust ment for age, sex, income, social support, an d duration of diabetes in linear regression models, there were significant graded relationships between greater depressive symptoms and higher serum l evels of cholesterol and triglycerides (P < 0.050). Similar, albeit less st atistically significant, relationships were found with higher levels of HbA (1c) (P = 0.104), diastolic blood pressure (P = 0.073), and LDL cholesterol (P = 0.176). Unexpectedly individuals who reported more depressive symptom s also had higher serum levels of HDL cholesterol (P = 0.047), The associat ions were not explained by differences in diabetes-related health behaviors . CONCLUSIONS- Depressive symptoms are marginally associated with suboptimal levels of HbA(1c), diastolic blood pressure, and LDL cholesterol, and signi ficantly associated with suboptimal levels of total cholesterol and triglyc eride levels. Prospective studies are required to determine whether improve d identification and management of depressive symptoms would enhance metabo lic control in this population.