825-P: Depressive Symptoms Are Associated with Lower Diabetes Self-Management in Adults with Type 1 Diabetes

Depression is increased in people with type 1 diabetes (T1D), and may lead to poor disease self-management and suboptimal glycemic control. Depressive symptoms were assessed in adults with and without longstanding T1D (mean±SD T1D duration 38±8.6 years).

A total of 414 participants with T1D (mean±SD age 51±9 years) and 488 participants without T1D (mean±SD age 55±9 years) completed the Beck Depression Inventory II (BDI-II) and the Diabetes Self-Management Questionnaire (DSMQ).

BDI-II scores were significantly higher in people with T1D (mean±SD 5.4±5.6%) than in those without T1D (3.8±4.7, p<0.0001). In age-adjusted linear regression models, BDI-II scores were higher in participants with T1D vs. those without T1D in both men (LSmean±SE 5.3±0.4 vs. 3.1±0.3, p<0.001) and women (5.6±0.4 vs. 4.4±0.3, p=0.018). Depressive symptoms were higher in women compared to men among participants without T1D (p=0.01), but not among adults with T1D (p=0.56). Among participants with T1D, 9.7% of women and 10.4% of men (p=0.81) reported clinically elevated symptoms of depression (>13), whereas 7.1% of women and 1.7% of men without T1D reported clinically elevated symptoms of depression (p=0.004). Among participants with T1D, a higher BDI-II score was significantly correlated to HbA1c (r=0.21, p=0.0005). In age, sex, and T1D duration adjusted linear regression models, BDI-II scores >13 were associated with significantly lower total scores on the DSMQ (p<0.0001), and on the DSMQ subscales for Glucose Management (p=0.0005), Dietary Control (p=0.002), and Physical Activity (p=0.006) but not Health Care Use (p=0.73). There were no differences in these associations by sex.

Our data demonstrate elevated levels of depressive symptoms in adults with T1D, particularly men, which were associated with lower self-management behaviors. Interventions are needed to address the role of depression on glycemic control and behaviors around glucose management, diet and physical activity in adults.