Depression is more common among people with type 2 diabetes (T2D) than in those without the condition and is also associated with a greater risk for serious complications, possibly because depressed individuals with T2D tend to neglect their medication regimen.

In a paper published last December in the Journal of Diabetes and Its Complications, Einstein researchers led by Jeffrey Gonzalez, Ph.D., associate professor of medicine and of epidemiology & population health, explored the connection between depression and medication adherence among 376 low-income, racially diverse adults with poorly controlled T2D. All participants filled out questionnaires to assess symptoms of depression.

The 83 people (22 percent of the group) who tested positive for major depressive disorder had a nearly threefold increased risk for low medication adherence compared with nondepressed participants. Somewhat surprisingly, adherence was also a problem for individuals who reported feeling fatigued but were not depressed: They were 77 percent more likely than nonfatigued individuals to have low medication adherence.

“We observed a significant relationship between depression and medication nonadherence in our study,” Dr. Gonzalez says. “In addition, fatigue may have a connection to the risk for nonadherence that is independent of depression’s role. These results suggest that health providers should be alert to the presence and severity of depression as well as the presence of fatigue when trying to improve medication adherence among their patients with type 2 diabetes.”