Diabetes-Related Distress Increases Risk for Nonadherence

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Diabetes-related distress and symptoms are risk factors for medication nonadherence in diabetes.
Diabetes-related distress and symptoms are risk factors for medication nonadherence in diabetes.

HealthDay News -- Diabetes-related distress and depression symptom severity are risk factors for medication nonadherence in type 2 diabetes, according to a study published in Diabetes Care.

Jeffrey S. Gonzalez, PhD, from Yeshiva University in New York City, and colleagues examined the correlation between emotional distress and adherence to medication over time among ethnically and socioeconomically diverse adults treated for type 2 diabetes. Participants completed validated self-reports (SRs) for diabetes distress and depression. Over 3 months, medication adherence was electronically monitored (EM) among 104 participants and validated SRs for adherence were also obtained.

The researchers found that there was a bivariate association for higher levels of SR and interview-based depressive symptom severity and diabetes-related distress with EM and SR nonadherence. Baseline diabetes distress was a significant independent predictor of EM and SR adherence at follow-up; SR depression also independently predicted EM and SR adherence and attenuated the effects of diabetes distress so they were no longer significant. This effect was driven by somatic, not cognitive-affective, symptoms of depression.

"Findings support diabetes-related distress and depression symptom severity as risk factors for type 2 diabetes medication nonadherence," the researchers wrote. "Somatic symptoms captured by depression measures, but not cognitive-affective symptoms, independently predict nonadherence and should be further investigated as a potential link between emotional distress and nonadherence."


  1. Gonzalez JS, Kane NS, Binko DH, Shapira A, Hoogendoorn CJ. Tangled up in blue: unraveling the links between emotional distress and treatment adherence in type 2 diabetes. Diabetes Care. 2016 Oct 17. doi:10.2337/dc16-1657 [Epub ahead of print].
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