Different associations of depressive subtypes with glycemic control.

Association of depression with glycemic control are not conclusive. While some studies found a positive association, others found none or found that diabetes distress is a mediating factor. These inconsistencies might be due to the complex symptomatology of depression. Depressive symptoms can range from sleep or appetite disorders to depressed mood and having crying spells. Thus, depressive symptoms can be divided into somatic and affective symptoms. This study investigated the associations of the different depressive subtypes with glycemic control. 923 patients completed the Center for Epidemiological Studies - Depression scale (CES-D) which offers subscales for somatic and affective symptoms. Linear regression analysis with HbA1c as dependent variable was conducted. Independent variables of interest were the somatic and affective scores of the CES-D controlled for demographic (age, gender, body mass index, education) and medical (diabetes type, diabetes duration, number of SMBG, late-complications) variables as well as diabetes distress. Both depressive subtypes were signifi cantly associated with HbA1c. A greater somatic symptomatology was associated with a higher HbA1c (β = .15; p = .001) whereas a greater affective symp- A219 For author disclosure information, see page A810. CATEGORY ADA-Funded Research & Guided Audio Tour poster Behavioral Medicine, Clinical Nutrition, Education, and Exercise POSTERS PSYCHOSOCIAL, BEHAVIORAL MEDICINE tomatology was associated with a lower HbA1c (β = -.15; p = .001). Greater diabetes distress was associated with higher HbA1c (β = .13; p = .001). Linear regression with depressive symptoms in general (CES-D total score) as independent variable revealed no signifi cant association (β = -.01; p = .86). This study demonstrated that depression is a complex condition and offers an explanation for the inconsistencies in current literature regarding associations with glycemic control. Only the differentiation of subtypes offered a more complete picture of the associations of depression with glycemic control. In clinical practice and further research, a closer look which symptoms of depression are present may be helpful to better understand depression as a vulnerability factor

Assessing physicians’ satisfaction with diabetes therapy: development and evaluation of a new questionnaire.

Questionnaires assessing the satisfaction of patients already exist, but no questionnaire assesses the satisfaction of physicians. However, physicians’ satisfaction with patient-communication and with diabetes therapy is a crucial factor for the effi cacy of diabetes therapy. A relevant part of patientcommunication is the discussion of blood glucose values with the patient. In order to systematically assess the perspective of physicians, we developed WITHDRAWN A232 For author disclosure information, see page A810. CATEGORY & Guided Audio Tour poster ADA-Funded Research Behavioral Medicine, Clinical Nutrition, Education, and Exercise POSTERS PSYCHOSOCIAL, BEHAVIORAL MEDICINE a questionnaire that assesses satisfaction of physicians with diabetes therapy in general (Sat-DT) and with the discussion of blood glucose values (SatBG) in particular. Data from 188 physicians who completed the questionnaire was analyzed. The fi nal Sat-DT scale comprised 13 items and achieved a Cronbach’s Alpha of 0.93 wit a mean item-total correlation of r=0.71. The fi nal Sat-BG scale comprised 10 items and achieved a Cronbach’s Alpha of 0.92 with a mean item-total correlation of r=0.73. Factor analysis (Varimax rotation) revealed two factors within the Sat-DT scale (65% explained variance): “Effects of diabetes therapy” and “costs and benefi ts.” The Sat-BG scale could be divided into “Usage of blood glucose data” and “effi cacy of the discussion” by factor analysis (76% explained variance). A greater satisfaction in both scales was associated with a greater satisfaction with the work as a physician (Sat-DT: r=0.2, p<.05; Sat-BG: r=0.32, p<.05), a greater satisfaction with therapy outcomes (Sat-DT: r=0.34, p<.05; Sat-BG: r=0.3, p<.05), and with a greater satisfaction with the results of working as a physician (Sat-DT: r=0.27, p<.05; Sat-BG: r=0.25, p<.05). This new questionnaire with its two scales is a reliable and valid assessment tool to measure the satisfaction of physicians. In future studies, this questionnaire can be used to investigate the infl uence of physicians’ satisfaction on diabetes therapy as well as how physicians’ satisfaction can be altered

Effect of Dairy Foods on Insulin Sensitivity and Pancreatic Function

Behavioral Medicine, Clinical Nutrition, Education, and Exercise Posters - 789-PPeter M. Clifton, Jordan Peters, Jennifer Keog