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. 2020 Feb 29;9(1):45.
doi: 10.1186/s13643-020-01302-z.

Association between subthreshold depression and self-care behaviors in people with type 2 diabetes: a systematic review of observational studies

Monika Shrestha  1   2 , Ashley Ng  3 , Amal Al-Ghareeb  4 , Fatimah Alenazi  5 , Richard Gray  5   6   7
Affiliations

Association between subthreshold depression and self-care behaviors in people with type 2 diabetes: a systematic review of observational studies

Monika Shrestha et al. Syst Rev. .

Abstract

Background: Self-care behaviors in people living with type 2 diabetes are important to achieving optimal glycemic control. Major depression in type 2 diabetes is associated with decreased adherence to self-care behaviors. The association between subthreshold depression and self-care behaviors, however, has not previously been systematically reviewed. The objective of this review is to determine the association between subthreshold depression and self-care behaviors.

Methods: A systematic search was performed in five electronic databases that included MEDLINE, EMBASE, PsycINFO, Emcare, and CINAHL. Any observational studies in adults with type 2 diabetes, investigating the association between subthreshold depression and any self-care behaviors, were included in the review. Qualitative studies, review articles, and gray literature were excluded. Two reviewers independently completed the title and abstract and full-text screening, appraised the study quality, and extracted the data. A third reviewer resolved any discrepancies between the reviewers if needed. Included articles were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Meta-analyses were not conducted because criteria for conducting such analyses were not met.

Results: A total of 6408 articles were identified through the database searching. After the abstract and full-text review, two articles met the inclusion criteria. One of the included study was cross-sectional while the other was a longitudinal study. Both studies showed inconsistent findings in the association between subthreshold depression and self-care behaviors. Important risks of bias were identified in the included studies.

Discussion: The evidence from the two included studies on a possible association between subthreshold depression and self-care behaviors in adults with type 2 diabetes was not consistent and potentially biased. Our review established a gap in knowledge and suggests that further high-quality studies are needed to examine the association between subthreshold depression and self-care behaviors in people with type 2 diabetes.

Systematic review registration: PROSPERO CRD42018116373.

Keywords: Depression; Self-care behavior; Self-management; Subthreshold depression; Systematic review; Type 2 diabetes.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flow chart showing the study selection process and search results
See this image and copyright information in PMC

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References

    1. Zheng Y, Ley SH, Hu FB. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nat Rev Endocrinol. 2018;14(2):88–98. doi: 10.1038/nrendo.2017.151. - DOI - PubMed
    1. Zimmet PZ, Magliano DJ, Herman WH, Shaw JE. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol. 2014;2(1):56–64. doi: 10.1016/S2213-8587(13)70112-8. - DOI - PubMed
    1. International Diabetes Federation . IDF diabetes atlas. 9 2019. - PubMed
    1. Khaledi M, Haghighatdoost F, Feizi A, Aminorroaya A. The prevalence of comorbid depression in patients with type 2 diabetes: an updated systematic review and meta-analysis on huge number of observational studies. Acta Diabetol. 2019;56(6):631–650. doi: 10.1007/s00592-019-01295-9. - DOI - PubMed
    1. Ali S, Stone MA, Peters JL, Davies MJ, Khunti K. The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med. 2006;23(11):1165–1173. doi: 10.1111/j.1464-5491.2006.01943.x. - DOI - PubMed

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