Correlates of depression among people with diabetes: The Translating Research Into Action for Diabetes (TRIAD) study

Prim Care Diabetes. 2010 Dec;4(4):215-22. doi: 10.1016/j.pcd.2010.07.002. Epub 2010 Sep 15.


Aim: The broad objective of this study was to examine multiple dimensions of depression in a large, diverse population of adults with diabetes. Specific aims were to measure the association of depression with: (1) patient characteristics; (2) outcomes; and (3) diabetes-related quality of care.

Methods: Cross-sectional analyses were performed using survey and chart data from the Translating Research Into Action for Diabetes (TRIAD) study, including 8790 adults with diabetes, enrolled in 10 managed care health plans in 7 states. Depression was measured using the Patient Health Questionnaire (PHQ-8). Patient characteristics, outcomes and quality of care were measured using validated survey items and chart data.

Results: Nearly 18% of patients had major depression, with prevalence 2-3 times higher among patients with low socioeconomic status. Pain and limited mobility were strongly associated with depression, controlling for other patient characteristics. Depression was associated with slightly worse glycemic control, but not other intermediate clinical outcomes. Depressed patients received slightly fewer recommended diabetes-related processes of care.

Conclusions: In a large, diverse cohort of patients with diabetes, depression was most prevalent among patients with low socioeconomic status and those with pain, and was associated with slightly worse glycemic control and quality of care.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cluster Analysis
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / diagnosis
  • Depression / epidemiology*
  • Diabetes Mellitus / blood
  • Diabetes Mellitus / epidemiology
  • Diabetes Mellitus / psychology
  • Diabetes Mellitus / therapy*
  • Female
  • Glycated Hemoglobin / metabolism
  • Health Care Surveys
  • Humans
  • Least-Squares Analysis
  • Linear Models
  • Logistic Models
  • Male
  • Managed Care Programs
  • Middle Aged
  • Mobility Limitation
  • Outcome and Process Assessment, Health Care*
  • Pain / psychology
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Self Care
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology
  • Young Adult


  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human