Visual Abstract

Psychosocial screening is not standard care in adults with T1D despite ADA recommendations. Depression interferes with daily life and physical health outcomes. The purpose of this study was to examine depressive symptoms, self-management behaviors, and A1C in adults with T1D.

Adults with T1D (N=899; 65% females; 25±14 years of age; 18-95 years) completed the Patient Health Questionnaire-8 (PHQ-8; □15 clinically elevated) and the Diabetes Self-Management Questionnaire (DSMQ); A1C was self-reported. DSMQ Total score and subscales with higher scores indicating higher engagement in self-management.

Women were significantly more likely to have clinically elevated symptoms of depression (10% men and 16% women; P=0.02). Higher PHQ-8 scores were associated with lower DSMQ Total score and subscales in both men and women, but A1C only in women. There was a significant sex by PHQ-8 interaction for A1C and the DSMQ Glucose Management subscale (Table).

Women with clinically elevated depressive symptoms had an average A1C that was 1.3% higher than women without elevated symptoms. Women with T1D with higher levels of depressive symptoms do not meet ADA recommended A1C <7% and they reported less frequent engagement in self-management behaviors. There is a critical need for intervention studies targeting glucose checking and insulin dose consistency, particularly, in women with T1D to improve self-management and A1C.


C. Geno rasmussen: None. J. K. Snell-bergeon: Stock/Shareholder; Self; GlaxoSmithKline plc. H. K. Wise: None. V. Shah: Advisory Panel; Self; Medscape, Sanofi, Research Support; Self; Dexcom, Inc., Eli Lilly and Company, Insulet Corporation, Novo Nordisk, Sanofi, vTv Therapeutics. K. A. Driscoll: None.


National Center for Advancing Translational Sciences (UL1TR002535)

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