Mental Health and Diabetic Complications: A Two-Way Link

TOPLINE:

In individuals with type 1 diabetes (T1D) or type 2 diabetes (T2D), mental health disorders increase the risk of developing chronic diabetic complications and vice versa across all age groups.

METHODOLOGY:

• Improving diabetes screening and management may be aided by knowledge of the relative timing and correlation between mental health issues and chronic diabetic complications.
• Researchers examined people with and without T1D and T2D who had no prior history of mental illness or a chronic diabetes complication using data from the US national healthcare claims database (data collected from 2001 to 2018).
• In order to explore potential connections, the start and existence of mental health issues and chronic diabetes complications were noted.
• Age groups included 0–19, 20–39, 40–59, and > 60 years old.

TAKEAWAY:

• Researchers compared 356,630 people without diabetes (51.8% women) with 44,735 patients with T1D (47.5% women) and 152,187 with T2D (46.0% women).
• In all age categories, the presence of chronic diabetes complications was associated with a higher risk of mental health disorders; patients aged 60 years or older had the highest risk (hazard ratio [HR], 2.9).
• Similarly, in all age categories, the diagnosis of a mental health illness raised the risk for long-term diabetic problems; patients between the ages of 0 and 19 had the highest risk (HR, 2.5).
• Across all age groups, with the exception of those who were 60 years of age or older, patients with T2D had a considerably higher risk of mental health disorders and a lower risk of chronic diabetes complications than those with T1D.
• The type of diabetes had no effect on the bidirectional link between chronic diabetic complications and mental health issues (P >.05 for all interactions).

IN PRACTICE:

“Clinicians and healthcare systems likely need to increase their focus on MHDs [mental health disorders], and innovative models of care are required to optimise care for both individuals with type 1 diabetes and those with type 2 diabetes,” the researchers concluded.

SOURCE:

Diabetes Care released the study online under the direction of Maya Watanabe of the University of Michigan’s Department of Biostatistics in Ann Arbour, Michigan.

LIMITATIONS:

The study’s reliance on the 9th and 10th revision codes of the International Classification of Diseases may have resulted in incorrect classification of diabetes type, chronic diabetes complications, and mental health disorders. The severity and onset of the symptoms were not recorded in the data. It’s possible that the results cannot be applied to populations outside of the US.

DISCLOSURES:

The Juvenile Diabetes Research Foundation (formerly Breakthrough T1D) provided funding for the study. A few writers disclosed that they had been paid for speaking engagements or expert testimony, that they have received research funding, and that they have consulted for numerous pharmaceutical and medical device companies or served on medical or digital advisory boards.