Diabetes added to high risks for people with severe mental illness

June 13, 2018, University of California, San Francisco

People with severe mental illness are more than twice as likely to have Type 2 diabetes, with even higher risks among patients who are African American or Hispanic, according to a new study led by UCSF.

Among more than 15,000 patients with severe mental , 28.1 percent had Type 2 diabetes, the researchers reported in the study publishing June 13, 2018, in Diabetes Care. In contrast 12.2 percent of the general population are estimated to have the disease.

Among racial minorities with severe mental illness, the incidences were 36.9 percent for Hispanics, 36.3 percent for African Americans and 30.7 percent for Asians—versus 25.1 percent for whites.

The study, which was led by first author Christina Mangurian, MD, MAS, associate professor of psychiatry at UCSF, follows her previous research that linked severe mental illness to low levels of testing for diabetes, low rates of HIV testing—despite a significantly higher likelihood of being HIV positive—and, among women, low rates of screening for cervical cancer.

Food Insecurity, Low Income, Unstable Housing Add to Risks

"Antipsychotic medications prescribed for conditions like schizophrenia and bipolar disorder may cause weight gain and impact cholesterol levels and insulin resistance," said Mangurian, who is Vice Chair for Diversity and Health Equity in the UCSF Department of Psychiatry and a member of the UCSF Weill Institute for Neurosciences. "Additionally, people with severe mental illness have more tenuous life circumstances, including , low income and unstable housing situations, which all increase their risk of diabetes. Stressors such as structural racism compound these problems in minorities."

Prediabetes, in which blood sugar levels are elevated, was also found to be high among people with severe mental illness. Close to half were found to have prediabetes, versus an estimated one-third of the . The condition was more common among those who were minorities and tended to emerge as young as age 20, the researchers noted.

The study utilized a database of health information from patients with severe mental illness collected by Kaiser Permanente Northern California. The study included patients who were also in the Kaiser Permanente diabetes registry and assessed the prevalence of prediabetes by analyzing patients' hemoglobin A1C and fasting glucose levels.

"We were able to leverage Kaiser Permanente's extensive electronic health record data to improve our understanding of the burden of diabetes and prediabetes in people with severe mental illness and develop insights on how to address racial/ethnic and age disparities in this high-risk population," said senior author Julie Schmittdiel, Ph.D., research scientist at the Kaiser Permanente Northern California Division of Research.

"The results of the study indicate that we should be screening all patients with severe mental illness for diabetes," said Mangurian. "I view this as an opportunity to change how doctors think about health screening and to help prevent diabetes. By diagnosing prediabetes early, we can help make lifestyle modifications or start medicine so that they don't develop ."

Explore further: Low cervical cancer screening rates found among mentally ill

Related Stories

Low cervical cancer screening rates found among mentally ill

April 17, 2017
Women enrolled in California's Medicaid program (Medi-Cal) who have been diagnosed with severe mental illness have been screened for cervical cancer at much lower rates than other women, according to a new study by researchers ...

Low-cost preventive care may help heart health for people with serious mental illness

September 4, 2017
People with serious mental illness, such as bipolar disease and schizophrenia, die on average 25 years earlier than their peers. A common cause of death is heart disease that frequently develops unchecked due to lack of preventive ...

Patients with severe mental illnesses slip between cracks in HIV testing

January 18, 2017
People with bipolar disorder, schizophrenia and major depression with psychosis may be up to 15 more likely than the general population to be HIV positive, but are only marginally more likely to be tested for the virus, according ...

People with and without mental health conditions receive preventive care at similar rates

October 19, 2017
People with schizophrenia and bipolar disorder received preventive health screenings at rates similar to or higher than people without mental illnesses, according to a study of more than 800,000 patients published today in ...

Patients with severe mental illness rarely tested for diabetes, despite high risk, study shows

November 9, 2015
Although adults with serious psychiatric disorders are at high risk for diabetes, a large study led by UC San Francisco reveals that low-income patients on Medicaid are rarely screened for it. The findings support growing ...

Having a severe mental illness often means dying before your time

May 2, 2018
People with severe mental illness have at least a two-and-a-half times higher risk of dying than the general population. In essence, people with severe mental illness are dying for the same sorts of reasons as the rest of ...

Recommended for you

Using mushrooms as a prebiotic may help improve glucose regulation

August 16, 2018
Eating white button mushrooms can create subtle shifts in the microbial community in the gut, which could improve the regulation of glucose in the liver, according to a team of researchers. They also suggest that better understanding ...

Cardiovascular disease related to type 2 diabetes can be reduced significantly

August 16, 2018
Properly composed treatment and refraining from cigarette consumption can significantly reduce the risk of cardiovascular disease resulting from type 2 diabetes, according to a study published in the New England Journal of ...

Blood test may identify gestational diabetes risk in first trimester

August 16, 2018
A blood test conducted as early as the 10th week of pregnancy may help identify women at risk for gestational diabetes, a pregnancy-related condition that poses potentially serious health risks for mothers and infants, according ...

Weight gain after smoking cessation linked to increased short-term diabetes risk

August 15, 2018
People who gain weight after they quit smoking may face a temporary increase in the risk of developing type 2 diabetes, with the risk directly proportional to the weight gain, according to a new study from Harvard T.H. Chan ...

Evening preference, lack of sleep associated with higher BMI in people with prediabetes

August 15, 2018
People with prediabetes who go to bed later, eat meals later and are more active and alert later in the day—those who have an "evening preference"—have higher body mass indices compared with people with prediabetes who ...

Healthy fat cells uncouple obesity from diabetes

August 14, 2018
About 422 million people around the world, including more than 30 million Americans, have diabetes. Approximately ninety percent of them have type 2 diabetes. People with this condition cannot effectively use insulin, a hormone ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.