TOP LINE:
In people with type 1 diabetes (DT1) or Type 2 diabetes (T2D), mental health disorders increase the risk of developing chronic diabetic complications and vice versa in all age groups.
METHODOLOGY:
- Improving diabetes screening and management can be facilitated by knowledge of the relative timing and correlation between mental health problems and chronic complications of diabetes.
- The researchers looked at people with and without type 1 diabetes and type 2 diabetes who had no history of mental illness or chronic diabetes complications, using data from the U.S. National Health Care Claims Database (data collected from 2001 to 2018).
- To explore potential links, the onset and existence of mental health problems and chronic complications of diabetes were noted.
- Age groups included 0–19 years, 20–39 years, 40–59 years, and >60 years.
TAKE AWAY:
- The 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).
- Across 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) of 2.9).
- Similarly, across all age categories, being diagnosed with a mental illness increased the risk of long-term diabetic problems; patients aged 0 to 19 years had the highest risk (HR, 2.5).
- In all age groups except those aged 60 years or older, patients with T2DM had a significantly higher risk of mental health disorders and a lower risk of chronic diabetes complications than those with T1DM.
- Diabetes type had no effect on the bidirectional association between chronic diabetic complications and mental health problems (P > 0.05 for all interactions).
IN PRACTICE:
“Clinicians and health systems likely need to increase their focus on mental health disorders (MHDs), and innovative models of care are needed to optimize care for people with type 1 diabetes and those with type 2 diabetes,” the researchers concluded.
SOURCE:
Diabetes Care published the study online under the direction of Maya Watanabe of the University of Michigan's Department of Biostatistics in Ann Arbor, Michigan.
BOUNDARIES:
The use of International Classification of Diseases revision 9 and 10 codes may have resulted in incorrect classification of diabetes type, chronic diabetes complications, and mental health disorders. Symptom severity and onset were not recorded in the data. The results may not be generalizable to populations outside the United States.
DISCLOSURES:
The Juvenile Diabetes Research Foundation (formerly Breakthrough T1D) funded the study. Some authors disclosed that they had received compensation for speaking engagements or expert testimony, received research funding, and consulted for numerous pharmaceutical and medical device companies or served on medical or digital advisory boards.
