Associations Between Depression and Diabetes Among Latinx Patients from Low-Income Households in New Mexico

Authors

Erik Erhardt, Department of Mathematics and Statistics, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.Follow
Cristina Murray-Krezan, Department of Internal Medicine, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA; Department of Medicine, University of Pittsburgh, 200 Meyran Ave., Suite 300, Pittsburgh, PA, 15213, USA.Follow
Lidia Regino, Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.Follow
Daniel Perez, Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.
Elaine L. Bearer, Department of Pathology, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA.Follow
Janet Page-Reeves, Office for Community Health, University of New Mexico, 1 University of New Mexico, Albuquerque, NM, 87131, USA; Department of Family & Community Medicine, University of New Mexico, MSC09 5065, 1 University of New Mexico, Albuquerque, NM, 87131, USA.Follow

Document Type

Article

Publication Date

3-1-2023

Abstract

Depression and diabetes are co-occurring epidemics. This article explores the association between depression and diabetes in a cohort of Latinx patients with diabetes from low-income households. Data were gathered in Albuquerque, New Mexico (U.S.) between 2016 and 2020 as part of a patient-engaged comparative effectiveness trial comparing two culturally appropriate diabetes self-management programs-the Chronic Care Model (CCM) and the standard of care, Diabetes Self-Management Support Empowerment Model (DSMS). We proposed that the program most culturally and contextually situated in the life of the patient would have the greatest impact on diabetes self-management. Participants were enrolled as dyads-226 Latinx diabetes patient participants (PPs) from low-income households and 226 social support participants (SSPs). Data gathered at baseline, 3, 6, and 12 months included a measure of depression and A1c testing. Outcomes between programs were analyzed using longitudinal linear mixed modeling, adjusted for patient demographic characteristics and other potential confounding covariates. Patient A1c had an initial slight decrease at 3 months in both programs. At CCM, patients with a very high A1c (greater than 10%) demonstrated a clinically meaningful decrease in A1c over time. Patients at CCM experienced a large initial decrease in depression and continued to decrease throughout the study, while patients at DSMS showed a slight initial decrease through 6 months, but depression increased again by 12 months, nearly rebounding to baseline levels. A subgroup analysis revealed that a higher baseline A1c was associated with higher depression, and patients with higher A1c achieved greater reductions in depression at CCM than at DSMS. CCM scored higher on Consumer Assessment of Healthcare Providers and Systems cultural competence (CAHPS-CC). Interpretation of results suggests that the more culturally, contextually situated program, CCM, had better outcomes. This study demonstrates that culturally and contextually situating a diabetes intervention can deliver improved benefits for Latinx patients.

Recommended Citation

Erhardt E, Murray-Krezan C, Regino L, Perez D, Bearer EL, Page-Reeves J. Associations between depression and diabetes among Latinx patients from low-income households in New Mexico. Soc Sci Med. 2023 Mar;320:115713. doi: 10.1016/j.socscimed.2023.115713. Epub 2023 Jan 21. PMID: 36706540.