Article Text
Abstract
Background Comorbid depression and diabetes mellitus (DM) compound challenges to disease management such as low health literacy, insufficient access to care, and social or linguistic isolation. Korean Americans (KAs), predominantly first-generation immigrants, suffer from a high prevalence of type 2 DM and depression. Limited research on KAs has prevented the development of effective interventions.
Objectives To compare the prevalence of depression in KAs with DM and all Americans with/without DM, and to explore correlates of comorbid DM and depression and strategies to address KAs' DM and depression.
Methods KAs' data were from a clinical trial of a community-based self-help intervention to improve KAs' DM and mental health outcomes. National Health and Nutrition Examination Survey data sets enabled comparison. Clinical indicators included hemoglobin A1C, lipid panel, and body mass index. Psychobehavioral indicators included self-efficacy for DM management, quality of life, and depression (Patient Health Questionnaire-9 (PHQ-9)).
Results More KAs with DM had depression (44.2%) than did all Americans with DM (28.7%) or without DM (20.1%). Significantly more KAs with DM had mild (29.3%) or clinical (14.9%) depression than did Americans with DM (mild, 17.2%; clinical, 11.5%) or without (mild, 13.8%; clinical, 6.3%). One of six KAs with DM (16.9%) thought of suicide or self-harm (Americans with/without =5.0%, 2.8%). The self-help intervention reduced the mean PHQ-9 from 5.4 at baseline to 4.1 at 12 months.
Limitations External validity might be limited; KAs' data were from one study site.
Conclusions The prevalence of depression and DM among KAs warrants the development of efficacious interventions.
Trial registration number NCT01264796.
- Depression
- Type 2 Diabetes
- Self-Care
- Minorities
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Footnotes
Contributors MTK and KBK had full access to the data and drafted the manuscript. JK researched data and YJ, HBL, and DL discussed/edited the manuscript.
Funding This study was supported by a grant from the National Institute of Diabetes and Digestive and Kidney Diseases (R18DK083936) and with material support from LifeScan, including devices (OneTouch glucometers, OneTouch UltraSoft test strips, and OneTouch UltraSoft Lancets) for study participants. Also, the Johns Hopkins Institute for Clinical and Translational Research supported the cost of blood serum laboratory tests.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or other supporters.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study received ethics approval by Johns Hopkins Medicine IRB.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement We shall make data available to the scientific community as few restrictions as feasible. However, because of the small sample size from a single ethnic community and some qualitative data (in Korean), PIs will maintain the electronic data file by removing all identifiable information. Data include demographic information, diabetes control status, and other standard blood serum test results. Further information can be obtained from the corresponding author.