Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring

Diabetes Care. 2009 May;32(5):804-6. doi: 10.2337/dc08-2111. Epub 2009 Feb 19.

Abstract

Objective: To determine whether the association between depressive symptoms and glycemic control is mediated by blood glucose monitoring (BGM).

Research design and methods: A total of 276 adolescents with type 1 diabetes (mean age +/- SD, 15.6 +/- 1.4 years) completed a measure of depressive symptoms. Sociodemographic and family characteristics were obtained from caregivers. BGM frequency and glycemic control were obtained at a clinic visit.

Results: Separate regression analyses revealed that depressive symptoms were associated with lower BGM frequency (B = -0.03; P = 0.04) and higher A1C (B = 0.03; P = 0.05) and that lower BGM frequency was associated with higher A1C (B = -0.39; P < 0.001). With depressive symptoms and BGM frequency included together, only BGM frequency was associated with A1C and depressive symptoms became nonsignificant (B = 0.02; P = 0.19). The Sobel test was significant (Z = 1.96; P < 0.05) and showed that 38% of the depression-A1C link can be explained by BGM.

Conclusions: BGM is a mediator between depressive symptoms and glycemic control in adolescents with type 1 diabetes.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Blood Glucose / analysis
  • Blood Glucose / metabolism*
  • Blood Glucose Self-Monitoring / psychology*
  • Depression / blood
  • Depression / epidemiology*
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / psychology*
  • Educational Status
  • Ethnicity
  • Female
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / therapeutic use
  • Insulin / administration & dosage
  • Insulin / therapeutic use
  • Male
  • Marital Status
  • Psychology, Adolescent*
  • Self Efficacy

Substances

  • Blood Glucose
  • Hypoglycemic Agents
  • Insulin