Symptoms of depression and anxiety in adults with type 1 diabetes: Associations with self-care behaviour, glycaemia and incident complications over four years – Results from diabetes MILES–Australia
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Symptoms of depression and anxiety in adults with type 1 diabetes : Associations with self-care behaviour, glycaemia and incident complications over four years – Results from diabetes MILES–Australia. / Schmitt, A; McSharry, J; Speight, J; Holmes-Truscott, E; Hendrieckx, C; Skinner, Timothy; Pouwer, F; Byrne, M.
In: Journal of Affective Disorders, Vol. 282, 01.03.2021, p. 803-811.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Symptoms of depression and anxiety in adults with type 1 diabetes
T2 - Associations with self-care behaviour, glycaemia and incident complications over four years – Results from diabetes MILES–Australia
AU - Schmitt, A
AU - McSharry, J
AU - Speight, J
AU - Holmes-Truscott, E
AU - Hendrieckx, C
AU - Skinner, Timothy
AU - Pouwer, F
AU - Byrne, M
PY - 2021/3/1
Y1 - 2021/3/1
N2 - ObjectiveTo examine whether symptoms of depression or anxiety predict glycaemia and incident diabetes complications four years later, and whether diabetes self-care behaviours mediate these associations, in adults with type 1 diabetes (T1DM).MethodsData of 205 adults with T1DM from the 2011 and 2015 Diabetes MILES–Australia surveys were analysed. Variables of interest were: baseline depression and anxiety (PHQ-8 and GAD-7, respectively) symptoms; HbA1c and incident complications at four-year follow-up; and self-care behaviours at both time points. Longitudinal associations were analysed using structural equation modelling.ResultsForty-two participants (20.6%) reported incident complications. Baseline depressive symptoms predicted higher HbA1c at follow-up indirectly via less optimal self-care at follow-up (β = 0.19, P = 0.011). Baseline anxiety was not independently associated with HbA1c or self-care at follow-up (P ≥ 0.64). Neither depressive nor anxiety symptoms predicted incident complications, although depressive symptoms were associated with less optimal self-care at baseline (β = -0.67, P < 0.001), and this predicted microvascular complications (β = -0.38, P = 0.044); however, the indirect association via self-care was not significant (β = 0.25, P = 0.067).LimitationsParticipants were self-selected; all study variables were assessed using self-report measures; and adjusting for baseline HbA1c was not possible.ConclusionsDepressive symptoms predicted suboptimal self-care behaviour and glycaemic outcome four years later, while anxiety symptoms did not. The findings suggest that tailored diabetes care should take the potential impact of comorbid depression into consideration to help people improve their diabetes self-care and achieve best possible health outcomes.
AB - ObjectiveTo examine whether symptoms of depression or anxiety predict glycaemia and incident diabetes complications four years later, and whether diabetes self-care behaviours mediate these associations, in adults with type 1 diabetes (T1DM).MethodsData of 205 adults with T1DM from the 2011 and 2015 Diabetes MILES–Australia surveys were analysed. Variables of interest were: baseline depression and anxiety (PHQ-8 and GAD-7, respectively) symptoms; HbA1c and incident complications at four-year follow-up; and self-care behaviours at both time points. Longitudinal associations were analysed using structural equation modelling.ResultsForty-two participants (20.6%) reported incident complications. Baseline depressive symptoms predicted higher HbA1c at follow-up indirectly via less optimal self-care at follow-up (β = 0.19, P = 0.011). Baseline anxiety was not independently associated with HbA1c or self-care at follow-up (P ≥ 0.64). Neither depressive nor anxiety symptoms predicted incident complications, although depressive symptoms were associated with less optimal self-care at baseline (β = -0.67, P < 0.001), and this predicted microvascular complications (β = -0.38, P = 0.044); however, the indirect association via self-care was not significant (β = 0.25, P = 0.067).LimitationsParticipants were self-selected; all study variables were assessed using self-report measures; and adjusting for baseline HbA1c was not possible.ConclusionsDepressive symptoms predicted suboptimal self-care behaviour and glycaemic outcome four years later, while anxiety symptoms did not. The findings suggest that tailored diabetes care should take the potential impact of comorbid depression into consideration to help people improve their diabetes self-care and achieve best possible health outcomes.
KW - Faculty of Social Sciences
KW - Diabetes mellitus
KW - Depression
KW - Anxiety
KW - Self-management behaviour
KW - Health outcomes
KW - Complications
U2 - 10.1016/j.jad.2020.12.196
DO - 10.1016/j.jad.2020.12.196
M3 - Journal article
C2 - 33601721
VL - 282
SP - 803
EP - 811
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
SN - 0165-0327
ER -
ID: 272777018