Depressive Symptoms and Glycemic Control in Adolescents With Type 1 Diabetes
Mediational role of blood glucose monitoring
- Meghan E. McGrady, 1,2,
- Lori Laffel, MD, MPH3,
- Dennis Drotar, PHD1,4,
- David Repaske, MD, PHD4,5 and
- Korey K. Hood, PHD1,4
- 1Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
- 2Department of Psychology, University of Cincinnati, Cincinnati, Ohio;
- 3Pediatric, Adolescent, and Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts;
- 4Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio;
- 5Diabetes Center, Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
- Corresponding author: Korey K. Hood, korey.hood{at}cchmc.org
Abstract
OBJECTIVE To determine whether the association between depressive symptoms and glycemic control is mediated by blood glucose monitoring (BGM).
RESEARCH DESIGN AND METHODS A total of 276 adolescents with type 1 diabetes (mean age ± SD, 15.6 ± 1.4 years) completed a measure of depressive symptoms. Sociodemographic and family characteristics were obtained from caregivers. BGM frequency and glycemic control were obtained at a clinic visit.
RESULTS Separate regression analyses revealed that depressive symptoms were associated with lower BGM frequency (B = −0.03; P = 0.04) and higher A1C (B = 0.03; P = 0.05) and that lower BGM frequency was associated with higher A1C (B = −0.39; P < 0.001). With depressive symptoms and BGM frequency included together, only BGM frequency was associated with A1C and depressive symptoms became nonsignificant (B = 0.02; P = 0.19). The Sobel test was significant (Z = 1.96; P < 0.05) and showed that 38% of the depression-A1C link can be explained by BGM.
CONCLUSIONS BGM is a mediator between depressive symptoms and glycemic control in adolescents with type 1 diabetes.
Footnotes
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The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
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- Received November 25, 2008.
- Accepted February 6, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
