Depressive symptoms, serious psychological distress, diabetes distress and cardiovascular risk factor control in patients with type 2 diabetes

Objective This study examined the association between cardiovascular disease (CVD) risk factor control and elevated depressive symptoms (EDS), serious psychological distress (SPD), and diabetes distress (DD) in patients with type 2 diabetes (T2DM). Methods This was a cross-sectional study of adults seen at an academic medical center and Veterans Affairs Medical Center in the southeastern US. Linear regression models were computed using CVD risk factors as clinically meaningful outcomes (glycosylated hemoglobin A1c (HbA1c); systolic (SBP) and diastolic (DBP) blood pressure; and low-density lipoprotein cholesterol (LDL-C)); EDS, SPD, and DD were primary independent variables. Covariates included sociodemographics and comorbidities. Results The sample consisted of 361 adults. Correlation analyses showed significant relationships between DD and HbA1c, DBP, and LDL-C. Adjusted linear regression models showed DD to be significantly associated with HbA1c and LDL-C, and SPD to be significantly associated only with LDL-C. In the fully adjusted model, DD remained significantly associated with HbA1c (β = 4.349; 95% CI (- 0.649, 2.222)). Conclusions In this sample of adults with T2DM, DD and SPD were significantly associated with CVD risk factors; however, after controlling for covariates, only DD was shown to be significantly associated with poor glycemic control. Practice implications Strategies are warranted to examine the relationship between DD and CVD risk factor control in patients with T2DM.