Takeaway
- People with diabetes mellitus (DM) who have comorbid severe mental illness (SMI) have better control of major cardiovascular (CV) risk factors than those without SMI.
- However, smoking cessation and retinopathy screening lag with SMI.
Why this matters
- Diabetes prevalence among people with SMI is more than twice that of the general population.
Study design
- Retrospective study of electronic health records for 269,243 adults with diabetes, including 4399 with comorbid SMI.
- Funding: NIH.
Key results
- Analyses were controlled for age, sex, race, urban area, BMI, primary care use, and medical facility.
- Adjusted relative risk (aRR) for HbA1c <7% with vs without SMI: 1.25 (P<.001).
- Mean adjusted HbA1c: 7.16% vs 7.47% (P<.001).
- For systolic BP (SBP) <140 mmHg:
- aRR with vs without SMI: 1.03 (P<.001).
- Mean SBP: 125 vs 128 mmHg (P<.001).
- For low-density lipoprotein cholesterol (LDL-C) <100 mg/dL:
- aRR with vs without SMI: 1.02 (P=.044).
- Mean adjusted LDL-C: 85 vs 88 mg/dL (P<.001).
- SMI group was less likely to quit smoking (aRR, 0.94; P=.001) or have retinopathy screening (aRR, 0.80; P<.001).
Limitations
- Data from 1 health system, may not be generalisable.
- No data on exposure to antipsychotics that raise diabetes risk.
- Smoking status unknown for 8%-14%.
References
References