• Raz Gross, Mark Olfson, Marc J Gameroff, Olveen Carasquillo, Steven Shea, Adriana Feder, Rafael Lantigua, Milton Fuentes, and Myrna M Weissman.
• Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY, USA. rg547@columbia.edu <rg547@columbia.edu>
• J Gen Intern Med. 2005 May 1; 20 (5): 460466460-6.

ContextMaintaining optimal glycemic control is an important goal of therapy in patients with diabetes mellitus. Patients of Hispanic ancestry have been shown to have high rates of diabetes and poor glycemic control (PGC). Although depression is common in adults with diabetes, its relationship to glycemic control remains unclear, especially among Hispanics.ObjectiveTo assess the association of depression with PGC in Hispanics.DesignData from a cross-sectional mental health survey in primary care were crosslinked to the hospital's computerized laboratory database.SettingUrban general medicine practice at a teaching hospital.PatientsTwo hundred and nine patients (mean [standard deviation] age, 57.1 [10.3] years; 68% females) with recent International Classification of Diseases, Ninth Revision (ICD-9) codes for diabetes mellitus, and 1 or more hemoglobin A(1c) (HbA(1c)) tests.Main Outcome MeasureProbability of PGC (HbA(1c)>or=8%).ResultsProbability for PGC steadily increased with severity of depression. Thirty-nine (55.7%) of the 70 patients with major depression had HbA(1c)>or=8%, compared with 39/92 (42.4%) in the minimal to mild depression group, and 15/47 (31.9%) in the no depression group (P(trend)=.01; adjusted odds ratio, 3.27; 95% confidence interval, 1.23 to 8.64, for moderate or severe depression vs no depression). Only 29 (41.4%) of the patients with major depression received mental health treatment in the previous year.ConclusionsIn this primary care sample of Hispanic patients with diabetes, we found a significant association between increasing depression severity and PGC. Yet, less than one half of the patients with moderate or severe depression received mental health treatment in the previous year. Improving identification and treatment of depression in this high-risk population might have favorable effects on diabetic outcomes.

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