Men with type 1 diabetes had a more than 7-fold odds of elevated depressive symptoms compared to men without diabetes.

Abstract

Objective: To examine: 1) differences in prevalence of elevated depressive symptoms between individuals with type 1 diabetes and without any type of diabetes overall and by sex; and 2) associations between depressive symptoms and HbA1c, self-management behaviors, and cardiovascular health.

Research design and methods: Adults (n = 414) with type 1 diabetes (mean age = 52 ± 9 years, mean duration = 38 ± 9 years; mean HbA1c = 7.8 ± 1.1 mg/dL or 177 mmol/L; 55 % female) and without any type of diabetes (n = 488; mean age = 51 ± 9 years; 51 % female) from the fourth study visit of CACTI, an observational study, completed questionnaires about depressive symptoms and dietary intake. Adults with type 1 diabetes completed a questionnaire about diabetes self-management. Hierarchical logistic regression models were used to examine demographic and clinical characteristics associated with depressive symptoms.

Results: Depressive scores were higher in people with type 1 diabetes overall and in both sexes. Men with type 1 diabetes had >7-fold increased odds of elevated depressive symptoms compared to men without diabetes (OR 7.4, 95 % CI: 2.1-26.4), whereas there were no increased odds in women (OR 1.4, 95 % CI: 0.6-2.9, significant sex x diabetes interaction [p = 0.03]). Higher levels of depressive symptoms were associated with both lower engagement in self-management behaviors and physical activity.

Conclusions: Our results demonstrate that there is an urgent need to screen adults with type 1 diabetes for depressive symptoms as part of routine medical care and to test interventions to minimize their impact on type 1 diabetes outcomes.