Depression treatment lacking in black, Hispanic adults with type 2 diabetes
Fewer black and Hispanic adults with type 2 diabetes receive pharmaceutical treatment for depressive symptoms than their white peers, according to findings published in the Journal of Diabetes and its Complications.
“Although depression affects approximately a quarter of patients with type 2 diabetes and is associated with worse glycemic control and diabetes-related outcomes, limited evidence exists of the patient characteristics that influence whether depression is treated in this population,” Caroline A. Presley, MD, MPH, assistant professor in the division of preventive medicine at the University of Alabama at Birmingham, and colleagues wrote.
Presley and colleagues examined medical records of 403 participants (mean age, 51 years; 60% women) from the Partnership to Improve Diabetes Education study to assess medication use, including antidepressants such as fluoxetine, venlafaxine and bupropion. All participants had type 2 diabetes and an HbA1c level of at least 7.5%, according to the researchers. Participants provided their own demographic information, including race and ethnicity, and completed a questionnaire to assess the potential presence of depressive symptoms. The researchers noted that only 4% of the study population had health insurance and 54% were making less than $10,000 per year.
Depression was confirmed by questionnaire in 52% of the study population and antidepressants were used by 18% of the total cohort, according to the researchers. Antidepressant use was observed in 26% of white adults compared with 8% of black adults and 6% of Hispanic adults (P < .001). The likelihood that a black adult would have an antidepressant prescription was 69% lower than the likelihood for a white adult (OR = 0.31; 95% CI, 0.12-0.79), and the chances were 73% lower for a Hispanic adult compared with a white adult (OR = 0.27; 95% CI, 0.1-0.75). The researchers noted that the odds that a woman would have received antidepressant therapy were improved by 92% compared with men (OR = 1.92; 95% CI, 1.04-3.55).
“Our results demonstrate that black and Hispanic patients are at risk to have untreated depression, which may worsen the known disparities in diabetes outcomes for these populations compared with white patients,” the researchers wrote. “To mitigate downstream effects of depression on outcomes in patients with type 2 diabetes, it is important to assess patients for depression and treat this condition appropriately in vulnerable populations, particularly racial and ethnic minorities.” – by Phil Neuffer
Disclosures: Presley reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.