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Emotional Distress and Treatment Adherence in T2D
Diabetes Care; ePub 2016 Oct 17; Gonzalez, et al
Diabetes-related distress and depression symptom severity are risk factors for type 2 diabetes (T2D) medication nonadherence, a recent study found. Ethically and socioeconomically diverse adults treated for T2D completed validated self-reports (SRs) for diabetes distress and depression and were administered semistructured depressions interviews, and provided blood samples for A1c. Medication adherence among 104 participants was electronically monitored (EM) over 3 subsequent moths. Researchers found:
- Higher levels of depressive symptom severity and diabetes-related distress showed a significant bivariate association with nonadherence.
- Baseline diabetes distress was a significant independent predictor of EM and SR at follow-up.
- SR depression was an independent predictor of adherence.
- Somatic symptoms independently predict nonadherence.
Gonzalez JS, Kane NS, Binko DH, Shapira A, Hoogendoorn CJ. Tangled up in blue: Unraveling the links between emotional distress and treatment adherence in type 2 diabetes. [Published online ahead of print October 17, 2016]. Diabetes Care. doi:10.2337/dc16-1657.
Depression is common in diabetes, with a reported prevalence of over 20%. Depression is related to higher A1c values when compared to patients with diabetes who do not have depression. This study shows that patients with diabetes and depressive symptoms, and even those without true depression but who have higher levels of diabetes-related distress, have a greater degree with nonadherence to their medical regimens. It is clear that to give the best care, we must be aware of the emotional state of our patients and if they have depression, make sure that the depression is addressed. —Neil Skolnik, MD