Description
Background: Diabetes is a chronic disease characterized by high levels of blood glucose. This disease affects many people worldwide and has been on the rise since 1958 and shows no signs of slowing. Hispanic adults are 1.9 times more likely to have diabetes than non-Hispanic White adults. The prevalence of diabetes among Hispanics in Imperial County is even higher with 2 to 2.5 times greater than in non-Hispanic Whites in the same region. Hispanics with diabetes have a twofold increase in depression compared to non-Hispanic Whites. Comorbidities of depression and diabetes can lead to various diabetes-related complications that can propagate a vicious cycle. Studies have suggested that social support can help patients adhere better to a diabetes self-care regimen (i.e. maintaining blood glucose monitoring, sustaining a healthy diet, exercising on a daily basis, etc). The purpose of this study was to assess the association between social support and depression among Hispanics with diabetes in Imperial County, California. Methods: Three hundred fifteen self-identified Hispanics from three clinics located in Imperial County with type 2 diabetes consented to participate in the study. To measure the effects of social support on depression in Hispanics who have type 2 diabetes, a multivariate logistic regression was performed using depression as the outcome variable and social support as the exposure variable. Depression was dichotomized into "major depression" and "no major depression" using the Patient Health Questionnaire-8 depression scale (PHQ-8). Social support was assessed using the using the Chronic Illness Resources Scale (CIRS). It was categorized into six different sources of support: (1) personal, (2) family, friends and neighborhood, (3) physicians and healthcare teams, (4) community organizations, (5) health-information media, and (6) workplace. However, because the scales' low internal validity, the items that made up community organizations, health-information media, and workplace support were assessed as individual variables and not as part of a subscale. Variables that were significant at p-value <0.10 in the bivariate associations were used to build a multivariate logistic regression model of depression. Results: Results from the multivariate models suggest that participants who reported having more personal social support were less likely to be depressed (OR= 0.72, 95% CI= 0.56- 0.93, p= 0.01). The negative relationship observed between major depression and personal support suggest that personal support is important to patients' depression status. However, physicians and healthcare teams who involve their patients in making decisions about their diabetes care were more likely to be depressed (OR= 1.22, 95% CI= 1.02- 1.45, p= 0.03). And, consistent with other studies, HbA1c levels were positively associated with major depression (OR= 1.20, 95% CI= 1.03- 1.40, p= 0.02).
