“Depression, Anxiety, and Stress in Diabetes” by Chlebowy

One of the most common causes of death in the United States is diabetes, and numerous studies are devoted to this condition and ways to cope with it. Byers et al. (2016) have noted that African American adults have higher rates of complications related to this disease than other ethnic groups. In the article “Relationships of Depression, Anxiety, and Stress with Adherence to Self-Management Behaviors and Diabetes Measures in African American Adults with Type 2 Diabetes,” Chlebowy et al. (2019) examined one’s ability to manage diabetes type 2 and possible complications in the form of depression, anxiety, and stress. While this article successfully addresses the connection between the states mentioned above, there are limitations related to sample size and type.

The article includes the assessment of both sides of the issue, which are self-management behavior and related complications, including depression, stress, and dietary risk. For this, Chlebowy et al. (2019) asked 42 participants to complete a survey on their current condition and then compared the results with their medical history (p. 72). Hence, the research included the analysis of a demographic survey and Depression, Anxiety, and Stress Scale 21 (Chlebowy et al., 2019). As a result, the authors concluded that there is no clear correlation between diabetes type 2 and the complications mentioned above.

The discussed topic is vital in terms of reduction in mortality rates among African American adults with diabetes type 2, but the usefulness of this research is also dependent on the possible bias of its authors. In this case, there is no bias in the article, as its findings are subsequently compared to some other studies on similar complications to demonstrate the necessity of further research (Chlebowy et al., 2019). However, the authors suggest a possible change in the results with more detailed research.

The presentation of the article is quite clear and supported by arguments, even though there are specific limitations of the research. They are connected to an insufficient number of self-report measures and the exclusion of patients in psychiatric care. Moreover, the sample size was small due to the use of data from a single clinic. Hence, only the change in sample size and its diversity would allow researchers to determine whether depression or anxiety can be independent variables for such a study (Chlebowy et al., 2019). Considering these limitations, the research was sufficient for further use.

The expansion of the study is possible in the case of the inclusion of more detailed data on the subject and consideration of various complications separately rather than in combination. The elements of the argument, which include diabetes and its complications, such as depression, anxiety, and other states, highlight the complexity of such a case but do not provide a clear picture of their impact on the health of a person with diabetes type 2. Therefore, the findings of this study should be the ground for further research of their interrelation for practical implementation.

The consideration of the most vulnerable population groups in terms of a specific disease is vital for the health indicators of the population as a whole. It supports my opinion on the necessity to reveal the measures that can be taken regarding self-management behaviors of people with such health conditions as diabetes type 2. Further research on the interrelation of diabetes and other states among a large and diverse sample would be essential for developing guidelines for controlling one’s health condition without external assistance.


Byers, D., Garth, K., Manley, D., & Chlebowy, D.O. (2016). Facilitators and barriers to type 2 diabetes self-management among rural African American adults. Journal of Health Disparities Research and Practice 9(1), 164-174.

Chlebowy, D. O., Batscha, C., Kubiak, N., & Crawford, T. (2019). Relationships of depression, anxiety, and stress with adherence to self-management behaviors and diabetes measures in African American adults with type 2 diabetes. Journal of Racial and Ethnic Health Disparities, 6(1), 71-76. Web.

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