The relationship between diabetes distress and clinical depression with glycemic control among patients with type 2 diabetes

Diabetes Care. 2010 May;33(5):1034-6. doi: 10.2337/dc09-2175. Epub 2010 Feb 11.


Objective: To clarify previous findings that diabetes distress is related to glycemic control and self-management whereas measures of depression are not, using both binary and continuous measures of depression.

Research design and methods: Four hundred and sixty-three type 2 patients completed measures of diabetes distress (Diabetes Distress Scale [DDS]) and clinical depression (Patient Health Questionnaire 8 [PHQ8]). PHQ8 was employed as either a binary (>or=10) or continuous variable. Dependent variables were A1C, diet, physical activity (PA), and medication adherence (MA).

Results: The inclusion of a binary or continuous PHQ8 score yielded no differences in any equation. DDS was significantly associated with A1C and PA, whereas PHQ8 was not; both DDS and PHQ8 were significantly and independently associated with diet and MA.

Conclusions: The lack of association between depression and glycemic control is not due to the use of a binary measure of depression. Findings further clarify the significant association between distress and A1C.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Affective Symptoms / diagnosis
  • Affective Symptoms / epidemiology
  • Affective Symptoms / psychology*
  • Aged
  • Depressive Disorder, Major / diagnosis
  • Depressive Disorder, Major / epidemiology
  • Depressive Disorder, Major / psychology*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Diabetes Mellitus, Type 2 / psychology*
  • Female
  • Glycated Hemoglobin / metabolism
  • Health Status
  • Humans
  • Hyperglycemia / epidemiology
  • Hyperglycemia / psychology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Regression Analysis
  • Self Care / psychology*
  • Self Care / statistics & numerical data
  • Surveys and Questionnaires


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human