Diabetes-related distress and severity of depression were confirmed as risk factors for type 2 diabetes medication nonadherence in a study involving 104 individuals.

Participants completed self-assessments for diabetes distress and depression, underwent semistructured depression interviews, and were monitored for A1C. Investigators electronically tracked medication adherence over 3 months, and also looked at participant self-reports of adherence. Among the results:

• Average 3-month medication adherence rate was 76% per electronic monitoring and 84% via self-report.
• Higher levels of depression and distress via both self-report and interview were significantly linked with nonadherence regardless of how adherence was measured.
• Diabetes distress significantly predicted nonadherence at follow-up.
• Self-rated depression independently predicted adherence no matter how it was measured.

The authors concluded that somatic symptoms independently predict nonadherence, and may be the link between emotional distress and nonadherence.