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Diabetes Metab J. 2017 Dec;41(6):440-448. English. Original Article.
Hapunda G , Abubakar A , Pouwer F , van de Vijver F .
Department of Psychology, University of Zambia, Lusaka, Zambia.
Department of Culture Studies, Tilburg University, Tilburg, The Netherlands.
Department of Public Health, Pwani University, Kilifi, Kenya.
Neuroassessment, Center for Geographic Medicine Research, Neurosciences Research Group, Kilifi, Kenya.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Work Well Unit, North-West University, Potchefstroom, South Africa.
School of Psychology, University of Queensland, Brisbane, Australia.


Depression is an established risk factor for cardiovascular diseases and mortality among individuals living with diabetes, and impaired self-care behaviors may play a mediating role. In Africa, this association is not very well known. In this study, we examined the associations between depressive symptoms and different aspects of diabetes self-care in Zambian individuals with diabetes mellitus.


A total of 157 individuals with diabetes mellitus participated. The sample was drawn from four city hospitals in Zambia. Diabetes self-care was assessed using the diabetes self-care inventory, and depression was assessed using the major depression inventory.


Fifty-nine percent of the sample had type 1 diabetes mellitus. Variations in self-care activities and behaviors were reported as least adhered to by individuals with type 1 and type 2 diabetes mellitus, in adolescent and adult patients. Regression analysis indicated that there was no association between total diabetes self-care and the depression total score. However, depression was associated with poor glucose testing and not eating meals on time by patients with diabetes.


Some variance on poor self-care was explained by demographic characteristics, specifically age, body mass index, and to some extent, socioeconomic status. Recognition and successful treatment of depression in patients with diabetes might help to optimize self-care behaviors, especially glucose testing and eating meals on time. However, this hypothesis needs further testing.

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