Association between symptoms of depression and glycaemic control may be unstable across gender

Aims Lloyd and colleagues (Diabetic Med 2000; 17, 198-202) have described a n association between poor glycaemic control and moderate to severe depress ion in male but not in female diabetes patients. However, the validity of t his study may be limited by its small sample size and the influence of unco ntrolled confounders. Therefore, we set out to replicate this study by inve stigating the associations between depression and glycaemic control in larg er samples, while controlling for potential confounders. Methods Out-patients with diabetes (n=174) and 1437 patient members of the Dutch Diabetes Association (DDA) completed the Hospital Anxiety and Depress ion Scale. Demographic and clinical characteristics were obtained using med ical records (out-patients) or self-report (DDA). Results After controlling for number of complications, years of education a nd body mass index, depression showed significant, low positive correlation s with HbA(1c) in three of the four female samples and in one of the four m ale samples. Only for out-patients with Type 2 diabetes was the correlation between HbA(1c) and depression significantly higher for women when compare d with men (0.19 vs. 0.04; P=0.02). Conclusions The association between depression and HbA(1c) may be stronger in women with Type 2 diabetes. Oestrogen levels and self-care behaviours ma y play a mediating role in this association. Further research is required b efore we can conclude that the association between symptoms of depression a nd glycaemic control differs across gender.