Transforming the diabetes outcomes for people with mental illness

Abstract

There is a complex bidirectional relationship between diabetes and mental illness, where diabetes is associated with an increased prevalence of a range of mental disorders and several mental illnesses increase the risk of diabetes. The reasons why people with mental illness are at higher risk of diabetes and vice versa are multifactorial. When diabetes and mental illness occur together, the outcomes for both conditions are worsened, and the co-morbidity places a higher burden on the individual living with the conditions.

Severe mental illness is associated with a twofold increased risk of diabetes, and the onset of diabetes is approximately 10 years earlier in people with mental illness than in the general population. Health behaviour interventions to reduce the incidence of diabetes may be less effective than previously thought. However, trials on obesity drugs, particularly glucagon-like peptide-1 receptor agonists, are showing promise. Diabetes care for people with severe mental illness seems to have improved in the past decade. Interventions have been developed to address the unique challenges of living with severe mental illness and diabetes.

Depression is twice as common in people with diabetes. Depression increases the risk of diabetes and vice versa. Although general population risk factors for depression apply to people with diabetes, diabetes-specific risk factors include the development of complications and insulin use in people with type 2 diabetes. Managing depression includes efforts to prevent depression, timely diagnosis and treatment with psychological or pharmacological treatments.

Health care professionals have a responsibility to ensure that people with mental illness and diabetes are not disadvantaged.

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Identifiers

ORCID for Richard Holt: orcid.org/0000-0001-8911-6744

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