Mental health problems spell trouble for diabetics

22 Nov 2020
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Mental health comorbidities are common among patients with type 2 diabetes mellitus (T2DM) and may lead to worse outcomes, a recent study has found.

This suggests that the management of T2DM should also include screening for mental health problems, so that interventions may be delivered in a timely manner.

The researchers conducted a retrospective observational analysis of 63,365 T2DM patients (mean age, 69.9±12.1 years; 54.0 percent male). Most (n=51,335) were without mental health comorbidities, which included depression, anxiety, schizophrenia, or substance use disorder.

In the remaining 12,030 patients, depression (13.6 percent) and anxiety (3.17 percent) were the most common comorbidities. The presence of such comorbidities increased the risk of all T2DM outcomes assessed in the study.

For example, the risk of 4-year all-cause mortality was significantly elevated in T2DM patients with at least one mental health comorbidity (adjusted odds ratio [OR], 1.24, 95 percent confidence interval [CI], 1.16–1.31; p<0.001), though different comorbidities led to different magnitudes of effect. Substance use disorder most strongly affected mortality risk.

Moreover, having at least one mental health comorbidity likewise increased the risk of all-cause hospitalization (adjusted OR, 1.16, 95 percent CI, 1.10–1.23; p<0.001), T2D hospitalization (adjusted OR, 1.51, 95 percent CI, 1.18–1.93; p=0.001), and emergency room visits (adjusted OR, 1.26, 95 percent CI, 1.21–1.32; p<0.001) among T2D patients. For all above outcomes, substance use disorder was the strongest risk factor.

“These findings underline the need for developing global management strategies to facilitate the prevention, early detection, diagnosis and monitoring of mental health comorbidities in T2D patients,” the researchers said.

“The high prevalence of multimorbidity found in T2D patients highlights the importance of providing continuity of care and person-centred approaches to improve the management and outcome of this chronic disease,” they added.

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