The Effect of Depression and Rurality on Diabetes Control

Helen N.C. Fu; Victoria G. Skolnick; Caroline S. Carlin; Leif Solberg; Abagail M. Raiter; Kevin A. Peterson

doi:10.3122/jabfm.2020.06.200041

The Effect of Depression and Rurality on Diabetes Control

Helen N.C. Fu, Victoria G. Skolnick, Caroline S. Carlin, Leif Solberg, Abagail M. Raiter, Kevin A. Peterson

Family Medicine and Community Health (Twin Cities)

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

BACKGROUND: Having depression and living in a rural environment have separately been associated with poor diabetes outcomes, but there little is known about the interaction between the 2 risk factors. This study investigates the association of depression and rurality with glycemic control in adults, as well as their interaction.

METHODS: This is a repeated cross-sectional study with data collected from 2010 to 2017 (n = 1,697,173 patient-year observations), comprising a near-complete census of patients with diabetes in Minnesota. The outcome of interest was glycemic control defined as hemoglobin A1c under 8%. We used a logit model with clinic-level random effects to predict glycemic control as a function of depression, patient rurality, and their interaction, adjusted for differences in observed characteristics of the patient, clinic, and patient's neighborhood.

RESULTS: Having depression was associated with lower probability of achieving glycemic control ( P < .001). Although rurality alone had no association with glycemic control, significant interactions existed between depression and rurality. Living in a small rural town mitigated the negative association between depression and glycemic control ( P < .001).

CONCLUSION: Although patients with depression had poorer glycemic control, living in a small rural town reduced the negative association between depression and glycemic control.

Original language	English (US)
Pages (from-to)	913-922
Number of pages	10
Journal	Journal of the American Board of Family Medicine
Volume	33
Issue number	6
DOIs	https://doi.org/10.3122/jabfm.2020.06.200041
State	Published - Nov 22 2020

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health under Award Number R18DK110732. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funding Information:
Funding: Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health

Publisher Copyright:
© 2020 American Board of Family Medicine. All rights reserved.

Keywords

Cross-Sectional Studies
Depression
Diabetes Mellitus
Glycated Hemoglobin A
Hyperglycemia
Logistic Models
Minnesota
Risk Factors
Rural Health Services

PubMed: MeSH publication types

Journal Article
Research Support, N.I.H., Extramural

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Publisher link

10.3122/jabfm.2020.06.200041

Find It

Find It at U of M Libraries

Cite this

@article{fb4f0bc0daff40098816a49e948eb419,

title = "The Effect of Depression and Rurality on Diabetes Control",

abstract = "BACKGROUND: Having depression and living in a rural environment have separately been associated with poor diabetes outcomes, but there little is known about the interaction between the 2 risk factors. This study investigates the association of depression and rurality with glycemic control in adults, as well as their interaction.METHODS: This is a repeated cross-sectional study with data collected from 2010 to 2017 (n = 1,697,173 patient-year observations), comprising a near-complete census of patients with diabetes in Minnesota. The outcome of interest was glycemic control defined as hemoglobin A1c under 8%. We used a logit model with clinic-level random effects to predict glycemic control as a function of depression, patient rurality, and their interaction, adjusted for differences in observed characteristics of the patient, clinic, and patient's neighborhood.RESULTS: Having depression was associated with lower probability of achieving glycemic control ( P < .001). Although rurality alone had no association with glycemic control, significant interactions existed between depression and rurality. Living in a small rural town mitigated the negative association between depression and glycemic control ( P < .001). CONCLUSION: Although patients with depression had poorer glycemic control, living in a small rural town reduced the negative association between depression and glycemic control.",

keywords = "Cross-Sectional Studies, Depression, Diabetes Mellitus, Glycated Hemoglobin A, Hyperglycemia, Logistic Models, Minnesota, Risk Factors, Rural Health Services",

author = "Fu, {Helen N.C.} and Skolnick, {Victoria G.} and Carlin, {Caroline S.} and Leif Solberg and Raiter, {Abagail M.} and Peterson, {Kevin A.}",

note = "Funding Information: Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health under Award Number R18DK110732. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: Funding: Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health Publisher Copyright: {\textcopyright} 2020 American Board of Family Medicine. All rights reserved.",

year = "2020",

month = nov,

day = "22",

doi = "10.3122/jabfm.2020.06.200041",

language = "English (US)",

volume = "33",

pages = "913--922",

journal = "Journal of the American Board of Family Medicine",

issn = "1557-2625",

publisher = "American Board of Family Medicine",

number = "6",

}

TY - JOUR

T1 - The Effect of Depression and Rurality on Diabetes Control

AU - Fu, Helen N.C.

AU - Skolnick, Victoria G.

AU - Carlin, Caroline S.

AU - Solberg, Leif

AU - Raiter, Abagail M.

AU - Peterson, Kevin A.

N1 - Funding Information: Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health under Award Number R18DK110732. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: Funding: Research reported in this publication was supported by the National Institute of Diabetes And Digestive and Kidney Diseases of the National Institutes of Health Publisher Copyright: © 2020 American Board of Family Medicine. All rights reserved.

PY - 2020/11/22

Y1 - 2020/11/22

N2 - BACKGROUND: Having depression and living in a rural environment have separately been associated with poor diabetes outcomes, but there little is known about the interaction between the 2 risk factors. This study investigates the association of depression and rurality with glycemic control in adults, as well as their interaction.METHODS: This is a repeated cross-sectional study with data collected from 2010 to 2017 (n = 1,697,173 patient-year observations), comprising a near-complete census of patients with diabetes in Minnesota. The outcome of interest was glycemic control defined as hemoglobin A1c under 8%. We used a logit model with clinic-level random effects to predict glycemic control as a function of depression, patient rurality, and their interaction, adjusted for differences in observed characteristics of the patient, clinic, and patient's neighborhood.RESULTS: Having depression was associated with lower probability of achieving glycemic control ( P < .001). Although rurality alone had no association with glycemic control, significant interactions existed between depression and rurality. Living in a small rural town mitigated the negative association between depression and glycemic control ( P < .001). CONCLUSION: Although patients with depression had poorer glycemic control, living in a small rural town reduced the negative association between depression and glycemic control.

AB - BACKGROUND: Having depression and living in a rural environment have separately been associated with poor diabetes outcomes, but there little is known about the interaction between the 2 risk factors. This study investigates the association of depression and rurality with glycemic control in adults, as well as their interaction.METHODS: This is a repeated cross-sectional study with data collected from 2010 to 2017 (n = 1,697,173 patient-year observations), comprising a near-complete census of patients with diabetes in Minnesota. The outcome of interest was glycemic control defined as hemoglobin A1c under 8%. We used a logit model with clinic-level random effects to predict glycemic control as a function of depression, patient rurality, and their interaction, adjusted for differences in observed characteristics of the patient, clinic, and patient's neighborhood.RESULTS: Having depression was associated with lower probability of achieving glycemic control ( P < .001). Although rurality alone had no association with glycemic control, significant interactions existed between depression and rurality. Living in a small rural town mitigated the negative association between depression and glycemic control ( P < .001). CONCLUSION: Although patients with depression had poorer glycemic control, living in a small rural town reduced the negative association between depression and glycemic control.

KW - Cross-Sectional Studies

KW - Depression

KW - Diabetes Mellitus

KW - Glycated Hemoglobin A

KW - Hyperglycemia

KW - Logistic Models

KW - Minnesota

KW - Risk Factors

KW - Rural Health Services

UR - http://www.scopus.com/inward/record.url?scp=85096814446&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85096814446&partnerID=8YFLogxK

U2 - 10.3122/jabfm.2020.06.200041

DO - 10.3122/jabfm.2020.06.200041

M3 - Article

C2 - 33219070

AN - SCOPUS:85096814446

SN - 1557-2625

VL - 33

SP - 913

EP - 922

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

IS - 6

ER -

The Effect of Depression and Rurality on Diabetes Control

Abstract

Bibliographical note

Keywords

PubMed: MeSH publication types

UN SDGs

Publisher link

Find It

Other files and links

Fingerprint

Cite this