Mental health and diabetes complications: a two-way connection

Top line:

Mental illness increases the likelihood of developing chronic diabetic complications in people of all ages with diabetes, and vice versa. Type 1 diabetes (T1D) or Type 2 diabetes (Type 2 diabetes).

Methodology:

• Understanding the relative timing and association between chronic diabetes complications and mental disorders may aid in improving diabetes screening and care.
• Using a US national health insurance claims database (data taken from 2001 to 2018), the researchers analyzed people with and without type 1 and type 2 diabetes who had no previous psychiatric disorders or chronic diabetes complications.
• We identified the occurrence and presence of chronic diabetes complications and psychiatric disorders and determined their possible associations.
• Individuals were stratified by age: 0–19, 20–39, 40–59, and ≥60 years.

remove:

• The researchers analyzed 44,735 people with type 1 diabetes (47.5% women) and 152,187 people with type 2 diabetes (46.0% women), and matched them with 356,630 individuals without diabetes (51.8% women).
• The presence of chronic diabetes complications increased the risk of mental disorders in all age groups, with the highest risk seen in patients aged 60 years or older (hazard ratio 0.015; 0.015; [HR]2.9).
• Similarly, a diagnosis of psychiatric disorders increased the risk of chronic diabetes complications in all age groups, with the highest risk seen in patients aged 0–19 years (HR, 2.5).
• In all age groups except those aged 60 years or older, patients with type 2 diabetes had a significantly higher risk of mental disorders and a lower risk of chronic diabetic complications compared with patients with type 1 diabetes.
• The bidirectional association between mental disorders and chronic diabetes complications was not affected by the type of diabetes (P > .05 for all interactions.

Exercise:

“Clinicians and health systems will need to place greater emphasis on MHD. [mental health disorders]”Innovative models of care are needed to optimize care for both patients with type 1 and type 2 diabetes,” the authors wrote.

sauce:

The study was led by Shinya Watanabe of the Department of Biostatistics at the University of Michigan in Ann Arbor, Michigan. Publish online in Diabetes Care.

Limitations:

This study was based on International Classification of Diseases, 9th and 10th Revision codes, which may have led to misclassification of mental disorders, chronic diabetic complications, and type of diabetes. The data did not capture symptom onset and severity. Findings may not be generalizable to populations outside the United States.

Disclosure:

This study was supported by the Juvenile Diabetes Research Foundation (now Breakthrough T1D). Some authors reported receiving speaking fees, expert testimony fees, or research support, and some declared serving on medical or digital advisory boards or serving as consultants for various pharmaceutical or medical device companies.