چکیده (انگلیسی):

Background:Prevention, or slowing the progression, of diabetic nephropathy is one of the important goals in diabetes
care. Although the impact of depression is a concern in patients with diabetes, it is unknown whether there is an
association between adherence to hypoglycemic medication and the decline of renal function in comorbid patients
with diabetes and depression. We will conduct a cohort study aimed at examining (1) depression as a predictor of
renal function decline, and (2) how adherence to hypoglycemic medication relates to depression and renal function
decline in patients with type 2 diabetes.
Methods/Design:In this multicenter cohort study, 550 patients with type 2 diabetes aged 20 years and older will be
recruited at 20 outpatient clinics in general medicine and psychiatry. We will measure depression (Patient Health
Questionnaire), medication adherence (medication possession ratio, Morisky Medication Adherence Scale, and one-item
hypoglycemic medication adherence scale), and renal function (urinary albumin-creatinine ratio and estimated glomerular
filtration rate) at baseline and at the 12-month follow-up. The primary endpoint is decline of renal function at 12 months.
The secondary endpoints include clinical variables, quality of life, and the attitude of professionals toward depression. We
will perform multivariable linear regression analysis to evaluate the effects of medication adherence on the decline of
renal function in comorbid patients with type 2 diabetes and depression.
Discussion:To our knowledge, this will be the first study to examine how adherence to hypoglycemic medication
relates to the decline of renal function in comorbid patients with type 2 diabetes and depression. The results of the
study will have implications for practitioners of diabetes care, policy makers, and researchers for the prevention and
treatment of diabetic nephropathy.
Trial registration:UMIN000017513 (Registered on May 22, 2015)