Depression and glycemic control in adolescent diabetics: evaluating possible association between depression and hemoglobin A1c

Abstract Objectives The objective of this study was to test whether glycemic control varies between adolescent patients diagnosed with type 1 or type 2 diabetes who are depressed and those who are not, after controlling for confounding factors. We hypothesized that diabetic children who have depression or a high risk to develop depression will have worse glycemic control, as indicated by higher hemoglobin A1c (HbA1c) values. Study design This was a retrospective case-control study. Methods A chart review was conducted in the Section of Endocrinology at St. Christopher's Hospital for Children in Philadelphia. Multivariate linear regression was used to determine effects of individual variables. Results A total of 214 records were included out of 263 reviewed. Significant differences were observed in type 1 diabetics (n = 156) between depressed and non-depressed patients in the percentage of females in the group ( P  = .002), the duration of diabetes ( P  = .005), age at diagnosis ( P  = .01), hemoglobin A1c ( P  = .03), and the percentage of those with a HbA1c greater than 14% ( P  = .03). Depression was associated with significant increases in HbA1c values in type 1 diabetics ( P P  = .055) was observed between sex and depression. Given the small sample of children with type 2 diabetes, we were unable to perform any meaningful statistical analysis in this subgroup of patients. Conclusions We have detected a significant association between depression and glycemic control in adolescent girls with type 1 diabetes. This association appears to be moderated by sex. Depressed patients with type 2 diabetes generally display higher HbA1c values than their non-depressed counterparts.