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200 UNDERDIAGNOSIS OF DEPRESSION AMONG LOW-INCOME, PREDOMINANTLY LATINO, TYPE 2 DIABETICS.
  1. E. Swant1,
  2. L. Wyatt1
  1. 1Department of Family Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.

Abstract

Background Comorbid depression affects approximately 20% of diabetics and is associated with poor glycemic control, poor adherence to diet and medications, increased risks of diabetic complications, and greater mortality rates, especially among Latinos, contributing to increased health care costs. Underdiagnosis of depression is established in Caucasian diabetics; however, only a few studies have shown that Latino diabetics are less likely to discuss or have depression assessed by their physician.

Objective This pilot study examines the prevalence of a clinical diagnosis of depression in low-income, predominantly Latino, type 2 diabetic patients who score positive on a depression screen.

Methods One hundred sixty adult family medicine patients at Mid Valley Comprehensive Health Center were randomly selected and screened for depression using the Patient Health Questionnaire (PHQ-9). Of these patients, a subset of type 2 diabetic patients who scored greater than or equal to 10 on the PHQ-9 were selected for the study sample. Retrospective chart abstraction was performed to determine patient demographics, HbA1c within 6 months of PHQ-9, and if a clinical diagnosis of depression was documented.

Results Thirty-two diabetic patients had a total PHQ-9 greater than or equal to 10. Only 47% were clinically diagnosed with depression. There was no statistical difference in the average HbA1c of patients clinically diagnosed with depression (average HBA1c = 8.3, range 6.2-13.7) compared with patients not diagnosed (average HbA1c = 8.1, range 5.6-13.4).

Conclusion Low-income, predominantly Latino, type 2 diabetic patients who have symptoms of at least moderate depression are underdiagnosed with depression by their provider.

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