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Research on depression and T2D showed depression impaired adherence to diabetes care, highlighting the need for integrated models addressing both conditions.
Research indicates that depression complicates type 2 diabetes (T2D) management by impairing adherence to essential self-care regimens, such as blood glucose monitoring and medication compliance. However, research is limited on the adherence to annual diabetes care visits and examinations, which are critical for effective management and prevention of complications.
To address this gap, Rossella Messina, PhD, and colleagues explored the crucial link between depression and adherence to diabetes care guidelines within the Local Healthcare Authority from Romagna, Italy. The study, published in Healthcare, showed that depression significantly impacted compliance with recommended annual assessments. Additionally, the authors wrote that systemic efforts are warranted to increase adherence rates in this patient population to ensure comprehensive and effective diabetes management.
The retrospective cohort study included 13,285 patients with onset T2D between 2015 and 2017, with follow-up from January 2018 to December 2022. The mean age of disease onset was 61.1 years. The researchers used hospital discharge records and antidepressant prescriptions to identify depression. The authors measured adherence to diabetes care guidelines using the Guideline Composite Indicator (GCI).
The researchers found that the prevalence of depression following diabetes onset increased from 3.0% in 2018 to 8.9% in 2022. Initial analysis revealed that patients with depression, both before and after diabetes onset, demonstrated higher CGI rates compared to those without depression (58.0% and 58.2% vs 51.8%, respectively). However, after propensity-score adjustment, the researchers observed that from 2021 to 2022 patients with prediabetes depression exhibited 5% lower compliance rates (P≤0.05).
The age-stratified analysis showed distinct patterns in adherence. Patients aged 65 years and older with depression (both pre- and post-diabetes) had significantly lower adherence to guidelines in later years of follow-up. The authors concluded that “older adults with depression face additional barriers to maintaining consistent diabetes care, potentially due to greater disease burden, cognitive decline, or reduced social support.”
“Future research should focus on developing and evaluating integrated care models that concurrently address diabetes and depression, particularly among older adults who appear to be at greater risk for non-adherence,” noted the researchers. “Integrated care models addressing both diabetes and depression are crucial for improving health outcomes.”
