Diabetes Distress, Depressive Symptoms, and Cardiovascular Health in Adults With Type 1 Diabetes.
Margaret M McCarthy, Robin Whittemore, Georica Gholson and 1 others
PMID 31693550WHAT IT FOUND
In adults with type 1 diabetes, higher diabetes distress was linked to higher A1c and cholesterol.
Depressive symptoms were common but were not linked to A1c after other factors. Assess both in clinic.
Key findings
01Diabetes distress was associated with higher hemoglobin A1c and total cholesterol.
02In adjusted analysis, diabetes distress remained associated with hemoglobin A1c, while depressive symptoms were not.
03Depressive symptoms were correlated with fear of hypoglycemia and hemoglobin A1c, but not significantly with step counts or BMI.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 83 adults were enrolled, and the sample was mostly female and White, so results may not apply broadly. The study was cross-sectional, so it cannot show whether distress causes higher A1c or cholesterol, or whether poor control raises distress. Step counts were analyzed for only 67 participants, and missing step days were filled with each participant's mean. Height and weight were self-reported, so BMI may be inaccurate. The authors did not know how many participants were being treated for depression with counseling or medication. They did not achieve desired sample size, and small numbers may have missed real differences.
Declared interests
The authors report no conflicts of interest. Publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that treating diabetes distress will lower A1c or cholesterol. This was a cross-sectional survey, so it shows association, not cause. Depressive symptoms were not independently associated with A1c after adjustment.