Associations of depression and diabetes distress with self-management behavior and glycemic control.

Schmitt, Andreas; Bendig, Eileen; Baumeister, Harald; Hermanns, Norbert; Kulzer, Bernhard

doi:10.1037/hea0001037

Cited by 114Diabetes Management and EducationDiabetes Management and ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Associations of depression and diabetes distress with self-management behavior and glycemic control.

Schmitt, Andreas, Bendig, Eileen, Baumeister, Harald, Hermanns, Norbert, Kulzer, Bernhard·2021·Health Psychology

DOI 10.1037/hea0001037

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Abstract

OBJECTIVE: To analyze the independent associations of depression and diabetes distress with self-management and glycemic outcome in Type I (T1DM) and Type 2 diabetes (T2DM). METHOD: Six hundred six people with T1DM or T2DM participated in a cross-sectional survey including measures of depression (PHQ-9), diabetes distress (PAID-5), self-management behavior (DSMQ), and glycemic outcome (HbA1c). Structural equation modeling was performed to analyze the independent linear associations (standardized coefficients) between these variables. RESULTS: In those with T1DM (n = 339), both depressive symptoms and diabetes distress were associated with lower self-management (-0.34, p < .001, and -0.16, p = .007, respectively) and thereover (indirectly) with higher HbA1c (0.20, p < .001, and 0.10, p = .016, respectively); direct associations with HbA1c were not observed. In those with T2DM (n = 267), only depressive symptoms were associated with lower self-management (-0.41, p < .001) and thus (indirectly) with higher HbA1c (0.17, p < .001). Diabetes distress, by contrast, was directly associated with higher HbA1c (0.20, p = .003) but not with self-management. CONCLUSIONS: The results are consistent with the hypothesis that depression is linked to less optimal diabetes self-management, thus leading to less optimal glycemic outcome. The associations were relatively consistent across diabetes types. Diabetes distress was additionally associated with higher glycemic levels, suggesting that people with both depression and diabetes distress might have the least optimal outcome. The conclusions are limited by the cross-sectional study design, self-report assessment of behavior, and potential bias arising from questionnaire measures. Further research is needed to support these findings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

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Diabetes-related distress may be more closely linked to glycaemic control than depression.
“Indeed, evidence now suggests that diabetes‐related distress may be more closely linked to glycaemic control than depression. 18 , 19 , 20”
From The effectiveness of cognitive behavioural therapy and third-wave cognitive behavioural interventions on diabetes-related distress: A systematic review and meta-analysis (2022) · cites this paper as [20]

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Abstract 123
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Authors: Schmitt, A., Bendig, E., Baumeister, H., Hermanns, N., & Kulzer, B.
Affiliations: German Diabetes Center Mergentheim (DE)
Universität Ulm (DE)
ORCID: Schmitt, Andreas
Bendig, Eileen
Baumeister, Harald
Hermanns, Norbert
Kulzer, Bernhard
Venue: Health Psychology
Publisher: American Psychological Association (APA)
Published: 2021-02
Volume: 40
Issue: 2
Pages: 113-124
ISSN: 0278-6133 (ISSN-L)
1930-7810
DOI: 10.1037/hea0001037
OpenAlex: W3110550372
Cited by: 114
References: 0
Citations by year: 2026: 18 · 2025: 30 · 2024: 28 · 2023: 15 · 2022: 16 · 2021: 7
FWCI: 7.19
Type: journal article
Language: en
Open access: closed
Locations: Health Psychology (publishedVersion)
PubMed (publishedVersion)
Funders: German Center for Diabetes Research (82DZD01101)
German Diabetes Foundation (375.10.15)
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: depression, diabetes distress, diabetes self-management, glycemic control, HbA1c, type 1 diabetes, type 2 diabetes, depressive symptoms, psychosocial factors in diabetes
MeSH terms: Self-Management, Glycemic Control, Adult, Cross-Sectional Studies, Depression, Diabetes Mellitus, Type 2, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Self Report

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Associations of depression and diabetes distress with self-management behavior and glycemic control.

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