Details

Autor(en) / Beteiligte

• Das‐Munshi, J.
• Ashworth, M.
• Dewey, M. E.
• Gaughran, F.
• Hull, S.
• Morgan, C.
• Nazroo, J.
• Petersen, I.
• Schofield, P.
• Stewart, R.
• Thornicroft, G.
• Prince, M. J.

Titel

Type 2 diabetes mellitus in people with severe mental illness: inequalities by ethnicity and age. Cross‐sectional analysis of 588 408 records from the UK

Ist Teil von

• Diabetic medicine, 2017-07, Vol.34 (7), p.916-924

Ort / Verlag

England: Wiley Subscription Services, Inc

Erscheinungsjahr

2017

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Aims To investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age. Methods We conducted a cross‐sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes. Results Relative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18–34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35–54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti‐psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness. Conclusions The relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti‐psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account. What's new? There is limited evidence of the association of severe mental illness with Type 2 diabetes mellitus in ethnic minorities. Using data from >500 000 people, we established that: (1) risk of Type 2 diabetes was increased up to 10‐fold in people with severe mental illness compared with groups without severe mental illness, irrespective of ethnicity, and was greatest in the youngest age groups; (2) prevalence of Type 2 diabetes was highest in Bangladeshi people with severe mental illness but was also high in all other South Asian, black African and black Caribbean groups; and (3) most associations persisted despite adjustment for anti‐psychotic prescriptions.