Younger age negatively impacts depression-associated exacerbation of hemoglobin A1c levels in type 2 diabetes: Implications for intervention

Adults with type 2 diabetes (T2DM) and depression are associated with higher hemoglobin A(1C) (HbA(1C)) compared to their nondepressed counterparts. Little is known about related clinical and demographic components contributing to these differences. We examined differences in HbA(1C) between adults who have T2DM with and without major depression. T tests and chi-square analyses measured differences in HbA(1C) and clinical/demographic variables. HbA(1C) was statistically higher in depressed participants compared to nondepressed participants. The difference was no longer statistically significant after controlling for age. Age and HbA(1C) were negatively correlated across the sample and were still correlated in each group independently. The interaction of age and HbA(1C) was moderated by depression status. Additionally, mechanisms for diabetes severity differences were assessed using moderation analyses and Blinder-Oaxaca decomposition technique. Seventy-four percent of the mean outcome HbA(1C) difference between depressed and nondepressed diabetic participants was explained by age. Furthermore, age was negatively correlated with clinical variables, such as diastolic blood pressure and cholesterol. Comparing age to smoking and nonsmoking participants, smokers were statistically younger. Younger adults with T2DM may require more attention regarding self-management, particularly in the context of depression. Depression should be screened and treated among individuals with diabetes since this exacerbates diabetes severity.