School of Medicine

Depression is a common condition often addressed in the outpatient setting. Patients with chronic medical illnesses, including diabetes, have a two to four fold increase in rates of depression. Those with diabetes and depression have higher rates of cardiovascular risk factors, noncompliance and health care expenditure. We completed a cross-sectional analysis of prevalence and characteristics of diabetic patients with and without depression at two distinct clinical settings, the UCSD Student Run Free Clinic Project (UCSD SRFCP) and UCSD Family Medicine clinics (UCSD FM). We also analyzed specific clinical measures (BMI, LDL, blood pressure) and their relationship to a depression diagnosis in those with comorbid diabetes. Each clinic setting serves different and specific populations however depression prevalence at both sites was similar to previously studied values, 23-26%. Rates of diabetes complications, including nephropathy, neuropathy, retinopathy and myocardial infarction were similar at both clinic sites (14.9-15.3%) as well. Similarly, in both clinical settings, depressed diabetic patients had more clinic visits over the course of a year than their non-depressed, diabetic counterparts. Within the UCSD SRFCP, HgA1c measurements were higher in depressed, diabetic patients compared to those who were not depressed. Within the UCSD FM clinics, Body Mass Index (BMI) was higher in depressed diabetic patients compared to non-depressed diabetic patients. Results of this study suggest diabetics in different healthcare settings have similar rates of depression and depression may affect certain clinical measures, like HgA1c and BMI. Further studies should further examine the relationship between depression and clinical outcomes, including how severity and changes in depressive symptoms correlate with clinical measures.