Aim: Polypharmacy, depression, and disease-specific distress are prevalent in type 2 diabetes (T2D). Polypharmacy may add to the emotional burden of treatment. Our group previously showed that insulin use is linked with increased distress; however, few studies have examined polypharmacy in relation to mental health in T2D. The present study examined cross-sectional relationships between the number of medications and emotional distress in a T2D sample.

Method: Adults with T2D (N=120, age=56(9.7), 64% female, 25% Hispanic/Latino) self-reported medication regimens and diabetes distress; depression was assessed by clinical interview. Due to severely skewed and kurtotic outcome variables, we used logistic regression with emotional distress dichotomized at clinical cutoffs. Independent relationships were assessed between the total number of medications (oral + insulin) and emotional distress, adjusting for age, sex, presence of diabetes complications, and insulin (yes/no). The moderating effect of insulin was examined.

Results: Number of prescribed medications (M=6.5(3.8)) was not associated with depression (OR=1.09 [95% CI: 0.97-1.21]), diabetes (OR=0.97 [95% CI: 0.88-1.07]) or regimen (OR=0.97 [95% CI: 0.88-1.08]) distress. In multivariate models, age was negatively associated with higher odds of depression (OR=0.95 [95% CI: 0.91-0.99]), diabetes (OR= 0.95 [95% CI: 0.91-0.99]) and regimen (OR=0.94 [95% CI: 0.90-0.99]) distress. Diabetes complications were associated with 3.08-fold increased odds (95% CI: 1.28-7.40) of depression. Insulin use did not moderate the relationship between number of medications and emotional distress.

Conclusion: The number of prescribed medications was not associated with depression or diabetes distress, suggesting that polypharmacy alone does not account for psychological aspects of perceived disease burden. As age was a notable predictor, younger individuals may be at more risk for the negative psychological impact of T2D and its treatment.


C.A. Solon: None. M.Z. Sears: None. C.J. Hoogendoorn: None. E.K. Seng: Consultant; Self; Eli Lilly and Company, GlaxoSmithKline plc. Other Relationship; Self; Haymarket Media. S.A. Margolis: None. J.S. Gonzalez: None.

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. More information is available at