Depressive symptoms predict change in glycemic control in adolescents with type 1 diabetes: rates, magnitude, and moderators of change
Version of Record online: 12 MAY 2011
© 2011 John Wiley & Sons A/S
Volume 12, Issue 8, pages 718–723, December 2011
How to Cite
Hood, K. K., Rausch, J. R. and Dolan, L. M. (2011), Depressive symptoms predict change in glycemic control in adolescents with type 1 diabetes: rates, magnitude, and moderators of change. Pediatric Diabetes, 12: 718–723. doi: 10.1111/j.1399-5448.2011.00771.x
- Issue online: 23 NOV 2011
- Version of Record online: 12 MAY 2011
- Submitted 1 October 2010. Accepted for publication 24 February 2011
- type 1 diabetes
Hood KK, Rausch JR, Dolan LM. Depressive symptoms predict change in glycemic control in adolescents with type 1 diabetes: rates, magnitude, and moderators of change.
Objective: To determine whether depressive symptoms in adolescents with type 1 diabetes predict change in glycemic control over time.
Research design and methods: A total of 145 adolescents (aged 13–18 yr) participated in two study visits (baseline and 6 months). They completed a measure of depressive symptoms (Children's Depression Inventory; CDI) and had their A1c values and adherence to blood glucose monitoring (BGM) documented.
Results: Three variables predicted A1c change over 6 months: CDI change score (B = 0.11; p < 0.001), BGM frequency at baseline (B = −0.21; p = 0.03), and A1c at baseline (B = −0.23; p = 0.002). A three-way interaction among these variables was significant (p < 0.01) and showed that adolescents with high adherence to BGM who were achieving optimal glycemic control (≤7.5%) at baseline were resistant to increasing A1c values, even if depressive symptoms worsened. However, as adherence to BGM declines, there is a synergistic effect with depressive symptoms to accelerate the increase of A1c values over time, making it more difficult to bring A1c back to optimal levels.
Conclusions: Results suggest that depressive symptoms are important predictors of A1c change by themselves as well as when considered with adherence to BGM. There is a need to screen for depressive symptoms and expand and develop prevention and intervention strategies in order to put adolescents with type 1 diabetes in the best position for optimal glycemic control.