Date of Award


Degree Name

Doctor of Philosophy


Interdisciplinary Health Sciences


Robert L. Anders


Type 2 diabetes is a common chronic metabolic disease affecting 23.6 million people (7.8%) in the U.S. and is the 6th leading cause of death among adults (CDC, 2007). Mexican-Americans, the largest group within the Hispanic U.S population, have double the rate of type 2 diabetes. Long-term glucose control (HbA1C) is essential to lessen the risk of diabetes complications; self-care demands for diabetes management may be overwhelming and creates stress that predisposes individuals to depression and affects long-term glucose control (Anderson et al., 2000; Black, 1999; Black, Markides, & Ray, 2003). The purpose of this study was to evaluate the presence of depression symptoms in Mexican-American adults with type 2 diabetes and its association with glucose control and identify factors that influence its association with perceived stress, and physical health. Participants (N=141) with self-report of type 2 diabetes for more than one year were recruited from private primary care clinics in El Paso, Texas. This was a quantitative, cross-sectional study that utilized parametric and non-parametric statistical analyses according to research questions addressed. Five questionnaires/instruments were completed by participants and a blood sample for HbA1C was obtained. No relationship was identified between HbA1C and depression symptoms; participants using insulin had a higher level of HbA1C than those with oral medications. Depression symptoms (BDI-II) score was related to sex, perceived stress, physical health, and medical history reported by participants. The perceived stress was related to age, education, and acculturation. Physical function was related to age and income and affected by the combination of BDI-II score and HbA1C results, and independently by perceived stress. The implications of this study are that the high prevalence of depression symptoms and its association with several study variables bring attention to the need for evaluating the psychological state of individuals with type 2 diabetes. Additionally, the percentage of participants outside the recommended HbA1C levels indicates a predisposition to diabetes complications. The treatment approach needs to include evaluation and management of depression on a regular basis for timely intervention. An interdisciplinary health care team approach for provision of holistic care of individuals with type 2 diabetes may be helpful in guarding against potential diabetes complications.




Received from ProQuest

File Size

114 pages

File Format


Rights Holder

Guillermina Rincon Solis

Included in

Nursing Commons