Different associations of depressive subtypes with glycemic control.

Association of depression with glycemic control are not conclusive. While some studies found a positive association, others found none or found that diabetes distress is a mediating factor. These inconsistencies might be due to the complex symptomatology of depression. Depressive symptoms can range from sleep or appetite disorders to depressed mood and having crying spells. Thus, depressive symptoms can be divided into somatic and affective symptoms. This study investigated the associations of the different depressive subtypes with glycemic control. 923 patients completed the Center for Epidemiological Studies - Depression scale (CES-D) which offers subscales for somatic and affective symptoms. Linear regression analysis with HbA1c as dependent variable was conducted. Independent variables of interest were the somatic and affective scores of the CES-D controlled for demographic (age, gender, body mass index, education) and medical (diabetes type, diabetes duration, number of SMBG, late-complications) variables as well as diabetes distress. Both depressive subtypes were signifi cantly associated with HbA1c. A greater somatic symptomatology was associated with a higher HbA1c (β = .15; p = .001) whereas a greater affective symp- A219 For author disclosure information, see page A810. CATEGORY ADA-Funded Research & Guided Audio Tour poster Behavioral Medicine, Clinical Nutrition, Education, and Exercise POSTERS PSYCHOSOCIAL, BEHAVIORAL MEDICINE tomatology was associated with a lower HbA1c (β = -.15; p = .001). Greater diabetes distress was associated with higher HbA1c (β = .13; p = .001). Linear regression with depressive symptoms in general (CES-D total score) as independent variable revealed no signifi cant association (β = -.01; p = .86). This study demonstrated that depression is a complex condition and offers an explanation for the inconsistencies in current literature regarding associations with glycemic control. Only the differentiation of subtypes offered a more complete picture of the associations of depression with glycemic control. In clinical practice and further research, a closer look which symptoms of depression are present may be helpful to better understand depression as a vulnerability factor