Men with type 1 diabetes had a more than 7-fold odds of elevated depressive symptoms compared to men without diabetes

To examine: 1) differences in prevalence of elevated depressive symptoms between individuals with type 1 diabetes (T1D) and without any type of diabetes overall and by sex; and 2) associations between depressive symptoms and HbA1c, self-management behaviors, and cardiovascular health.

Adults (n = 414) with T1D (mean age = 52 ± 9 years, mean duration = 38 ± 9 years; mean HbA1c = 7.8 ± 1.1 mg/dL or 177 mmol/L; 55 % female) and without any type of diabetes (n = 488; mean age = 51 ± 9 years; 51 % female) from the fourth study visit of CACTI, an observational study, completed questionnaires about depressive symptoms and dietary intake. Only adults with T1D completed a questionnaire about diabetes self-management. Hierarchical logistic regression models were used to examine demographic and clinical characteristics associated with depressive symptoms.

Depressive scores were higher in people with T1D overall and in both sexes. Men with T1D had >7-fold increased odds of elevated depressive symptoms compared to men without diabetes (OR 7.4, 95 % CI: 2.1-26.4), whereas there were no increased odds in women (OR 1.4, 95 % CI: 0.6-2.9, significant sex x diabetes interaction [p = 0.03]). Higher levels of depressive symptoms were associated with both lower engagement in self-management behaviors and physical activity.

Our results demonstrate that there is an urgent need to screen adults with T1D for depressive symptoms as part of routine medical care and to test interventions to minimize their impact on physical health outcomes.