Depressive Symptoms and Glycemic Control in Adolescents with Type 1 Diabetes:Mediational Role of Blood Glucose Monitoring
- Meghan E. McGrady, BA1,
- Lori Laffel, M.D., M.P.H.2,
- Dennis Drotar, PhD.3,5,
- David Repaske, M.D., Ph.D.4,5 and
- Korey K. Hood, Ph.D.3,5
- 1Department of Psychology, University of Cincinnati, Cincinnati, Ohio 45221
- 2Pediatric, Adolescent, & Young Adult Section, Genetics and Epidemiology Section, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215
- 3Center for Treatment Adherence, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229
- 4Diabetes Center, Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229
- 5Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, 45229
Abstract
Objective – Determine if the association between depressive symptoms and glycemic control is mediated by blood glucose monitoring (BGM).
Research Design and Methods – 276 adolescents with type 1 diabetes (age=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 (B=−0.03, p=0.04) were associated with lower BGM frequency; depressive symptoms were associated with higher A1c (B=0.03, p=0.05); and lower BGM frequency (B=−0.39, p<0.001) was associated with higher A1c. 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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- Received November 25, 2008.
- Accepted February 6, 2009.
- Copyright © American Diabetes Association
