Background: In 2019, more than 10.4% of the Rhode Island population had been diagnosed with diabetes. As a known contributor to heart disease and stroke, which are the leading and fifth leading causes of death, respectively, in the U.S., individuals with diabetes are at a higher risk of developing significant comorbidities. In previous studies, patients suffering from depression were less likely to comply with medications, physical activity and regular glucose testing regimens. Thus, the goal of this study is to determine if depression poses a barrier to the proper management of diabetes, specifically maintaining a HbA1c < 8%. Methods: Design: Mixed Methods - chart review & literature review Setting: Brown IM Clinic Participants: 142 unmanaged diabetic patients from January 2021 identified through Brown IM’s regular “Quality Bundle”. They were considered “unmanaged” if their HbA1c levels > 8% as of January 2021. Instrument: EMR chart review using EClinicalWorks Analysis: Used Excel to determine proportions of patients with and without a positive depression screen and unmanaged diabetes for ≥2 years. Results: Patients with a positive depression screen & HbA1c > 8% for ≥2 years = 14/24 = 58.3% Patients without a positive depression screen & HbA1c > 8% for ≥2 years = 51/118 = 43.2% Conclusion/Discussion: Based on the Brown Internal Medicine unmanaged diabetic patient population from January 2021, patients with a positive depression screen are more likely to have a HbA1c > 8% for 2 or more years. This may be due to a variety of factors including but not limited to poorer self-care, little interest in regular testing, decreased motivation to exercise, and lack of desire to take medications. Suggested interventions for Brown IM based on success found in the literature to improve both management and treatment were also reviewed and included Cognitive Behavioral Therapy, SSRIs, and a “VIP” treatment for co-morbid depression and diabetic patients.
Mendell, Kelsey N.,
"Depression as a Barrier to Diabetes Management: A Mixed-Methods Review"
(2021).
Gateways to Medicine, Health Care, and Research.
Brown Digital Repository. Brown University Library.
https://doi.org/10.26300/9h32-c569
The Gateways Program at the Warren Alpert Medical School of Brown University provides academically promising, motivated students new pathways to careers in the health sciences. This collection houses scholarly works produced by Master of Science in Medical Sciences (ScM) students …
