The relative impact of diabetes distress vs depression on glycemic control in hispanic patients following a diabetes self-management education intervention.

OBJECTIVES Studies in non-Hispanic populations have shown that depression and diabetes distress are associated with glycemic control. Although rates of depression and diabetes distress are high among Hispanics with diabetes, there is little research investigating the relationship between these factors and glycemic control in this population. The purpose of the current analysis was to examine the relative impact of change in diabetes distress and change in depressive symptoms on change in glycemic control in Hispanic patients following a diabetes self-management education (DSME) intervention. DESIGN We conducted a diabetes self-management education intervention in 23 Hispanic (predominantly Puerto Rican) and 168 non-Hispanic type 2 diabetes patients and measured glycemic control (HbA1c), depressive symptoms (CES-D), and diabetes distress (PAID) at baseline and 6 months. RESULTS In multiple linear regression, change in diabetes distress from baseline to six-month follow-up was significantly associated with change in HbA1c among Hispanic patients, such that a 10-point reduction on the PAID scale of diabetes distress was associated with a clinically significant reduction in HbA1c of .55 +/- .06% (P=.03). Change in depression was not associated with change in HbA1c (P=.59). Findings in non-Hispanic patients were similar. CONCLUSIONS Change in diabetes distress, but not change in depressive symptoms, was associated with change in HbA1c in both Hispanic and non-Hispanic patients. This analysis supports the utility of DSME in reducing diabetes distress and improving glycemic control among Hispanic patients.