Sumlin Lisa L, Garcia Theresa J, Brown Sharon A, Winter Mary A, García Alexandra A, Brown Adama, Cuevas Heather E
School of Nursing, The University of Texas at Austin, Austin, Texas (Ms Sumlin, Dr S. Brown, Dr AA Garcia, Dr Cuevas, Ms Winter, Dr A. Brown)
College of Nursing & Health Sciences, Texas A&M University-Corpus Christi, USA (Dr TJ Garcia)
Diabetes Educ. 2014 Nov-Dec;40(6):731-44. doi: 10.1177/0145721714538925. Epub 2014 Jun 17.
Depression affects millions of people worldwide and is prevalent among those with diabetes. The purpose of this review was to synthesize recent research on depression and adherence to dietary and physical activity recommendations in persons with type 2 diabetes (T2DM).
This systematic review is a subanalysis of an NIH-funded model-testing meta-analysis. Thirteen electronic databases were searched using terms: depression, adherence, T2DM, diabetes. Selected studies: were reported in English between 2000 and 2012, focused on adults with T2DM, and measured depression and dietary and/or physical activity adherence.
Twenty-seven studies involving 7266 participants were selected; participants were 54% female and 62 years of age, on average. When reported, depression prevalence in study samples ranged from 4.5% to 74%. Six intervention studies targeted diabetes treatment, with or without depression treatment; no studies focused solely on treating depression. Twenty-one descriptive studies examined relationships between depression and diet/physical activity adherence, finding a negative association. Only 2 of the 6 intervention studies examined this relationship; findings were inconsistent.
Depression was associated with lower adherence to diabetes self-care, as evidenced primarily by descriptive studies; results of intervention studies were conflicting. Future research should focus on the effects of treating depression on diabetes health outcomes.
抑郁症影响着全球数百万人，在糖尿病患者中也很常见。本综述的目的是综合近期关于2型糖尿病（T2DM）患者抑郁症以及对饮食和体育活动建议的依从性的研究。
本系统综述是一项由美国国立卫生研究院资助的模型测试荟萃分析的子分析。使用以下术语检索了13个电子数据库：抑郁症、依从性、T2DM、糖尿病。入选研究：2000年至2012年间以英文发表，聚焦于成年T2DM患者，并测量了抑郁症以及饮食和/或体育活动依从性。
选取了27项涉及7266名参与者的研究；参与者平均年龄为62岁，女性占54%。报告时，研究样本中的抑郁症患病率在4.5%至74%之间。六项干预研究针对糖尿病治疗，无论是否进行抑郁症治疗；没有研究仅专注于治疗抑郁症。21项描述性研究考察了抑郁症与饮食/体育活动依从性之间的关系，发现存在负相关。六项干预研究中只有两项考察了这种关系；结果不一致。
抑郁症与糖尿病自我护理的较低依从性相关，主要由描述性研究证明；干预研究的结果相互矛盾。未来的研究应关注治疗抑郁症对糖尿病健康结局的影响。
