Associations of depressive symptom severity with prevalence, awareness, treatment, and control of diabetes
| aOR (95% CI) | Depressive symptom severity* | P value for trend | ||||
| None 0–4 | Mild 5–9 | Moderate 10–14 | Moderately severe 15–19 | Severe 20 and higher | ||
| Prevalence | ||||||
| Proportion (%) | 13.6 | 19.1 | 22.3 | 24.1 | 22 | |
| Model 1† | 1 | 1.57 (1.34 to 1.83) | 2.05 (1.53 to 2.75) | 2.27 (1.65 to 3.12) | 2.14 (1.29 to 3.56) | |
| Model 2‡ | 1 | 1.42 (1.20 to 1.68) | 1.74 (1.30 to 2.33) | 1.77 (1.31 to 2.37) | 1.85 (1.08 to 3.16) | <0.001 |
| Model 3§ | 1 | 1.26 (1.04 to 1.53) | 1.41 (1.04 to 1.92) | 1.35 (0.99 to 1.86) | 1.43 (0.85 to 2.40) | 0.003 |
| Awareness¶ | ||||||
| Proportion (%) | 71.3 | 78.2 | 74.4 | 84.5 | 86.2 | |
| Model 1† | 1 | 1.47 (1.05 to 2.07) | 1.26 (0.74 to 2.15) | 2.43 (1.27 to 4.64) | 3.12 (0.85 to 11.38) | 0.002 |
| Model 2‡ | 1 | 1.53 (1.10 to 2.13) | 1.33 (0.79 to 2.24) | 2.59 (1.36 to 4.94) | 3.36 (0.92 to 12.26) | <0.001 |
| Model 3§ | 1 | 1.48 (1.06 to 2.06) | 1.17 (0.68 to 2.04) | 2.17 (1.13 to 4.15) | 2.82 (0.66 to 12.02) | 0.006 |
| Treatment¶ | ||||||
| Proportion (%) | 79.3 | 76.5 | 75.7 | 84 | 50.1 | |
| Model 1† | 1 | 0.88 (0.61 to 1.26) | 0.93 (0.59 to 1.46) | 1.63 (0.85 to 3.11) | 0.33 (0.16 to 0.67) | 0.326 |
| Model 2‡ | 1 | 0.83 (0.59 to 1.17) | 0.85 (0.54 to 1.32) | 1.45 (0.75 to 2.83) | 0.33 (0.16 to 0.66) | 0.181 |
| Model 3§ | 1 | 0.79 (0.55 to 1.13) | 0.75 (0.48 to 1.17) | 1.23 (0.60 to 2.55) | 0.25 (0.11 to 0.55) | 0.071 |
| Controlled** (HbA1c <7%) | ||||||
| Proportion (%) | 51.3 | 48.1 | 48.9 | 41.8 | 32.5 | |
| Model 1† | 1 | 0.81 (0.62 to 1.06) | 0.85 (0.57 to 1.28) | 0.49 (0.25 to 0.95) | 0.56 (0.27 to 1.19) | 0.007 |
| Model 2‡ | 1 | 0.85 (0.64 to 1.13) | 0.94 (0.63 to 1.40) | 0.52 (0.27 to 0.98) | 0.61 (0.31 to 1.20) | 0.028 |
| Model 3§ | 1 | 0.83 (0.63 to 1.10) | 0.92 (0.62 to 1.37) | 0.51 (0.27 to 0.98) | 0.57 (0.29 to 1.11) | 0.022 |
Statistically significant results are written in bold (p<0.05).
Data are weighted to non-institutionalized US population.
Multivariate logistic regression analysis was used.
*Depressive symptom severity was based on PHQ-9 score.
†Adjusted for age, sex, and race/ethnicity.
‡Adjusted for age, sex, race/ethnicity, body mass index, smoking, alcohol consumption, and physical activity.
§Adjusted for age, sex, race/ethnicity, body mass index, smoking, alcohol consumption, physical activity, marital status, education, household income, health insurance, and healthcare utilization.
¶Among participants with diabetes and available treatment data.
**Among participants with diabetes and available HbA1c data.
aOR, adjusted OR; HbA1c, glycated hemoglobin; PHQ-9, Patient Health Questionnaire-9.