Objectives: Assess whether adults with type 1 diabetes (T1D) with probable depression subsequently received pharmacological intervention for depression, and the impact of this intervention on glycemic control.

Research Design and Methods: Retrospective chart reviews were performed on adults ages 18-85 years, routinely screened for depression, with T1D of >1-year duration and no hemoglobinopathy, renal dysfunction (GFR <30), or dementia. Probable depression was defined by a score of ≥10 on the Patient Health Questionnaire (PHQ-9). Adults with probable depression at Time-1 were included if they had a follow-up PHQ-9 10-16 months later (Time-2) and a HbA1c within 1 month of completing each PHQ-9.

Results: The study included 93 participants (mean age=44 years, 55% female, 81% white, mean HbA1c 8.9%). At Time-1, 50 persons (53.8%) were prescribed anti-depressants. At Time-2, 5 additional persons (5.3%) received prescriptions. There were decreases in mean PHQ-9 scores (Time-1 15.99; Time-2= 4.55, p<.001) and HbA1c levels (Time-1= 9.3%; Time-2= 8.9%, p=.03). PHQ-9 scores related to HbA1c at each time point but did not relate to HbA1c change (p=0.48). There were marginally significant differences in PHQ-9 scores at Time-2 for those given anti-depressants (mean PHQ-9 = 5.75) versus those who were not (mean PHQ-9 = 2.82; p=.058), and a smaller decrease in HbA1c for those prescribed antidepressants (-.09) vs. those who were not (-.82; p= .042). Other interventions for depression (e.g., counseling) are not reliably captured in the EMR.

Conclusions: About 60% of adults with T1D and probable depression received anti-depressant medications. Despite an association between measures of depression and glycemic control, changes in each did not relate over 10-16 months. EMRs should improve documentation of therapeutic strategies to facilitate communication between providers working with depressed individuals and better inform future approaches to improve care.


B.J. Zaffuto: None. M. Greenfield: None. P.M. Trief: Research Support; Self; National Institute of Diabetes and Digestive and Kidney Diseases. C.P. Morley: None. R.S. Weinstock: Board Member; Self; JDRF. Consultant; Self; Insulogic LLC. Research Support; Self; Boehringer Ingelheim International GmbH, Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Insulet Corporation, Jaeb Center for Health Research, Kowa Research Institute, Inc., Medtronic, Tolerion, Inc.


Type 1 Diabetes Exchange QI Learning Collaborative

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 http://www.diabetesjournals.org/content/license.