Physical inactivity among adults with diabetes mellitus and depressive symptoms: Results from two independent national health surveys

Objective: To examine the association between depressive symptoms and physical inactivity in community samples of patients with diabetes mellitus (DM). Methods: Two representative samples of Israeli adults (age ≥21 years) were analyzed: The First Israeli National Health Interview Survey (INHIS-1) (n=9509) and the Israel National Health Survey (INHS) (n=4859). Information was obtained about past-month depressive symptoms, physician-diagnosed DM and physical activity. Multiple logistic regression models were used to examine the association between level of depressive symptoms and physical inactivity among individuals with DM, adjusting for potential confounders. Results: Prevalence of DM ranged from 7.2% (INHIS-1) to 8.7% (INHS). In both samples, physical inactivity was significantly more prevalent among persons with significant depressive symptoms, compared to those without depressive symptoms [INHIS-1: 67.0% vs. 50.6%; adjusted odds ratio (AOR): 1.57; 95% confidence interval (95% CI), 1.05-2.35, P=03; INHS: 71.4% vs. 43.9%; AOR: 2.67; 95% CI, 1.67-4.27, P<.0001]. Conclusions: Depressive symptoms were associated with a higher likelihood of physical inactivity in persons with DM. Body mass index of patients reporting no regular physical activity was elevated compared to persons who were physically active. This finding supports the view that identification and management of depression should be part of interventions designed to improve self care behaviors in patients with DM.