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Cited by 93Diabetes Management and ResearchDiabetes Management and EducationDiabetes, Cardiovascular Risks, and Lipoproteins

Depression in adults in the T1D Exchange Clinic Registry

Open access
Trief, Paula M., Xing, Dongyuan, Foster, Nicole C., Maahs, David M., Kittelsrud, Julie M., Olson, Beth A., Young, Laura A., Peters, Anne L. +5 more·2014·Diabetes Care
DOI 10.2337/dc13-1867
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Abstract

OBJECTIVE: Little is known about the frequency of depression in adults with type 1 diabetes (T1D) or its relationship to diabetes outcomes. The T1D Exchange clinic registry allowed us to explore depression in a large, heterogeneous sample. RESEARCH DESIGN AND METHODS: Participants ≥18 years old (N = 6,172; median age 34 years; median diabetes duration 16 years; 55% female; and 89% non-Hispanic white) completed the eight-item Patient Health Questionnaire (PHQ-8), a validated, reliable measure of current depression. Probable major depression was defined in four ways: PHQ-8 ≥10, PHQ-8 ≥12, per diagnostic algorithm, and as a continuous variable. Characteristics and clinical outcomes of those with and without depression were compared using logistic and linear regression models. RESULTS: A total of 4.6–10.3% of participants were classified as probable major depression depending on how defined. Participants classified as depressed were more likely female, nonwhite race/ethnicity, to have a lower household income and lower education level, to exercise less often, to miss insulin doses, and to have one or more complications (neuropathy, nephropathy, treatment for retinopathy, or cardiovascular/cerebrovascular disease) (all P < 0.01). HbA1c was higher in the depressed versus not depressed groups (8.4 ± 1.7% [68 ± 8.6 mmol/mol] vs. 7.8 ± 1.4% [62 ± 15.3 mmol/mol]; P < 0.001). Occurrence of one or more diabetic ketoacidosis events (11 vs. 4%; P < 0.001) and one or more severe hypoglycemic events (18 vs. 9%; P < 0.001) in the past 3 months was higher among depressed participants. CONCLUSIONS: In the T1D Exchange clinic registry, adults with probable major depression have worse clinical outcomes than those not depressed. Whether identification and treatment of depression improves diabetes outcomes requires study. Depression is common in T1D, and better identification and treatment of this comorbid condition is needed.

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Crossref · 10.2337/dc13-1867

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  • The prevalence/incidence of elevated DD in adults with T1D is substantially higher than the reported prevalence/incidence of clinical depression or elevated depression symptoms in this population.

    “They are also substantially higher than the reported prevalence/incidence of clinical depression or elevated depression symptoms in this population [18, 19].”

    From Diabetes distress in adults with type 1 diabetes: prevalence, incidence and change over time (2016) · cites this paper as [19]

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Authors
Trief, P. M., Xing, D., Foster, N. C., Maahs, D. M., Kittelsrud, J. M., Olson, B. A., Young, L. A., Peters, A. L., Bergenstal, R. M., Miller, K. M., Beck, R. W., Weinstock, R. S., & for the T1D Exchange Clinic Network
Affiliations
  • SUNY Upstate Medical University (US)
  • Jaeb Center for Health Research (US)
  • Barbara Davis Center for Childhood Diabetes, Aurora, CO
  • Avera McKennan Hospital & University Health Center (US)
  • Park Nicollet Health Services (US)
  • University of North Carolina at Chapel Hill (US)
  • University of Southern California (US)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
2014-05-10
Volume
37
Issue
6
Pages
1563-1572
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/dc13-1867
OpenAlex
W2013527479
Cited by
93
References
35
Citations by year
2026: 4 · 2025: 9 · 2024: 9 · 2023: 7 · 2022: 7 · 2021: 7 · 2020: 16 · 2019: 9 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 6 · 2014: 1 · 2013: 1
FWCI
4.83
Type
journal article
Language
en
Open access
Licence
Locations
  • Diabetes Care (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
depression, type 1 diabetes, adults, diabetes complications, glycemic control, HbA1c, diabetic ketoacidosis, hypoglycemia, Patient Health Questionnaire, comorbidities, socioeconomic factors, diabetes outcomes
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Depressive Disorder, Diabetes Mellitus, Type 1, Ethnicity, Female, Humans, Hypoglycemia, Male, Middle Aged, Outpatient Clinics, Hospital, Registries, United States, Prevalence, Diabetic Ketoacidosis, Young Adult

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