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Who Benefits from Diabetes Self-Management Interventions? The Influence of Depression in the Latinos en Control Trial

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Depressive symptoms are common among adults with diabetes. Depression and social support may influence diabetes self-management.

Purpose

This study aimed to examine change in depressive symptoms and the role of depression and support on clinical and dietary outcomes among Latinos with type 2 diabetes participating in a diabetes self-management intervention.

Methods

Participants (N = 252) were randomized to the intervention or usual care. Mixed effects models were used to examine interaction effects between intervention status and depressive symptoms (Centers for Epidemiologic Studies Depression (CES-D) score) and support for diabetes self-management behaviors at baseline. Outcomes were measured at baseline and 4 and 12 months and included dietary quality, physical activity, depressive symptoms, and hemoglobin A1c levels.

Results

Intervention participants had lower CES-D scores at follow-up than control participants. An interaction effect between intervention status and CES-D scores predicted diet quality.

Conclusion

Latinos with depressive symptoms may derive the greatest benefits from diabetes self-management interventions. Additional research on support during diabetes self-management interventions is warranted.

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Acknowledgments

This study was supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases Grant R18-DK-65985 and grants from the Robert Wood Johnson Foundation and Novo Nordisk Pharmaceutical (to MC Rosal). We acknowledge the contributions of the study staff and are grateful to the patients who participated and made the study possible.

Author’s Statement of Conflict of Interest and Adherence to Ethical Standards

Authors ML Wang, SC Lemon, MC Whited, and MC Rosal declare that they have no conflict of interest. All procedures, including the informed consent process, were conducted in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Authors and Affiliations

  1. Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA, 01655, USA

    Monica L. Wang Sc.D., M.S., Stephenie C. Lemon Ph.D. & Milagros C. Rosal Ph.D.

  2. Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA

    Monica L. Wang Sc.D., M.S.

  3. Department of Psychology, East Carolina University, 1001 East 5th Street, Greenville, NC, 27858, USA

    Matthew C. Whited Ph.D.

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  1. Monica L. Wang Sc.D., M.S.
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  2. Stephenie C. Lemon Ph.D.
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  3. Matthew C. Whited Ph.D.
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  4. Milagros C. Rosal Ph.D.
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Correspondence to Monica L. Wang Sc.D., M.S..

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Wang, M.L., Lemon, S.C., Whited, M.C. et al. Who Benefits from Diabetes Self-Management Interventions? The Influence of Depression in the Latinos en Control Trial. ann. behav. med. 48, 256–264 (2014). https://doi.org/10.1007/s12160-014-9606-y

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