Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care

J Clin Epidemiol. 2004 Sep;57(9):978-84. doi: 10.1016/j.jclinepi.2004.01.015.


Objective: Our study aimed to determine whether depressive symptoms are associated with poor self-care behaviors among patients with type 2 diabetes.

Methods: Study subjects were 168 patients with diabetes, aged >30 years, who had a diabetes history of 1-15 years. Using a self-reported questionnaire, we evaluated diabetes self-care behaviors and depressive symptoms. Self-care behaviors were evaluated in five categories: medication taking, self-monitoring of blood glucose (SMBG), diet, exercise, and participation in patient education programs. Depressive symptoms were evaluated using the Centers for Epidemiologic Studies-Depression (CES-D) scales. Multiple logistic regression analyses were used to determine the association between self-care behaviors and depressive symptoms.

Results: Higher depressive-symptom scores were associated with poor self-care behaviors, significantly with poor participation in education programs (odds ratio OR=1.21, 95% confidence interval CI=1.06-1.38) and poor diet (OR=1.11, 95% CI=1.01-1.22), and marginally with poor medication taking (OR=1.14, 95% CI=1.00-1.31). Depressive symptoms were not significantly associated with either SMBG or exercise.

Conclusions: These data suggest that the evaluation and control of depressive symptoms among diabetic patients would improve their adherence to self-care behaviors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring / psychology
  • Depression / etiology
  • Depression / psychology*
  • Diabetes Mellitus, Type 2 / psychology*
  • Diabetes Mellitus, Type 2 / therapy
  • Exercise / psychology
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Education as Topic
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Self Care / psychology*


  • Hypoglycemic Agents