Association between subthreshold depression and self-care behaviours in adults with type 2 diabetes: A cross-sectional study.

Abstract

AIMS AND OBJECTIVES\nThe aim of the study was to test the association between subthreshold depression and self-care behaviours in adults with type 2 diabetes (T2D) attending a tertiary healthcare service.\n\n\nBACKGROUND\nSuboptimal adherence to self-care behaviours is associated with poor glycaemic control. The estimated point prevalence of subthreshold depression in people with T2D is 17%. Two previous studies have examined the association between subthreshold depression and self-care behaviours in T2D, reported observations were inconsistent.\n\n\nDESIGN\nA cross-sectional observational study.\n\n\nMETHODS\nWe surveyed adults with T2D attending a tertiary healthcare facility in Nepal. Self-care behaviours and subthreshold depression were assessed using the Summary of Diabetes Self-care Activities and the Patient Health Questionnaire-9, respectively. We used linear and logistic regression to test the association of subthreshold depression with total and individual self-care behaviours. Our reporting complies with STROBE reporting guideline for observational research.\n\n\nRESULTS\nJust over a third (37%) of the participants had subthreshold depression. People with subthreshold depression had slightly lower total diabetes self-care score compared to those with no depression. More than half of participants with subthreshold depression had suboptimal adherence to diet, physical activity and foot care. Subthreshold depression was associated with total self-care score (B\xa0=\xa0-0.27, 95% CI: -0.54, -0.01). In addition, association between subthreshold depression and diet adherence was observed (AOR\xa0=\xa00.26, 95% CI: 0.15, 0.44).\n\n\nCONCLUSIONS\nSubthreshold depression is associated with decreased adherence to self-care behaviour in people with T2D. Identification and treatment of subthreshold depression in T2D may lead to better adherence to diabetes self-care behaviours.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nThe recognition and treatment of subthreshold depression warrants further investigation as a strategy to improve the adherence to self-care behaviours.