The association of depression with diabetes management among urban American Indians/Alaska Natives in the United States, 2011.

Objective: To determine the relationship between depression and diabetes management among urban American Indians/Alaska Natives (AI/ANs).

Design: Retrospective, cross-sectional analysis of medical records.

Setting: 33 Urban Indian Health Organizations that participated in the Indian Health Service Diabetes Care and Outcomes Audit.

Patients: 3,741 AI/AN patient records.

Main Outcome Measures: Diabetes management outcomes, including HbA1c, smoking, BMI, systolic blood pressure, creatinine, total cholesterol, and receipt of preventive services.

Results: Individuals with depression and diabetes were 1.5 times more likely to smoke than individuals with diabetes but without depression (OR=1.51; 95% Cl: 1.23, 1.86), controlling for age, sex, and facility. After adjustment, the geometric mean BMI in diabetes patients with depression was 3% higher than in patients without depression (β=.034; 95% CI: .011, .057).

Conclusions: Urban AI/ANs with diabetes and depression are more likely to smoke and have higher BMI than those with diabetes but without depression. These findings inform programmatic efforts to address the care of patients with both depression and diabetes.