Depression and hemoglobin A1c in type 1 and type 2 diabetes: the role of self-efficacy
William P Sacco1, Cathy A Bykowski
1Department of Psychology, University of South Florida, Tampa, FL 33620, USA. sacco@cas.usf.edu
Aims:
To examine a self-efficacy explanation of the finding that depression is related to hemoglobin A1c (A1c) level in people with type 1 but not type 2 diabetes.
Methods:
Cross-sectional design involving 124 participants with type 1 (n=32) and type 2 (n=92) diabetes. Participants completed measures of depression and diabetes-related self-efficacy. A1c was obtained from medical records.
Results:
Replicating prior findings, A1c was significantly correlated with depression in type 1 participants (r=.51, p<.01), but not in type 2 participants (r=.11, ns). As hypothesized, A1c was significantly correlated with self-efficacy among type 1 participants (r=-.42, p<.05) but not among type 2 participants (r=-.01, ns). Self-efficacy also mediated the effect of A1c on depression among the type 1 participants (Z=2.21, p<.05).
Conclusion:
In people with type 1, but not type 2 diabetes, A1c levels are related to diabetes adherence mastery (self-efficacy), which mediates the link between A1c and depression. Results are discussed with regard to the proposal that perceptions of ineffective control over one's health play a role in the development of depression (a consequence model of depression in diabetes).
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