Tags

Type your tag names separated by a space and hit enter

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.
Diabet Med. 2017 07; 34(7):916-924.DM

Abstract

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.

Authors+Show Affiliations

Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.Department of Primary Care and Public Health Sciences, King's College London, London.Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.South London and Maudsley NHS Foundation Trust, London.Blizard Institute, Barts and London School of Medicine and Dentistry, London.Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.Cathie Marsh Institute for Social Research, University of Manchester, Manchester.Department of Primary Care and Population Health, University College London, London, UK.Department of Primary Care and Public Health Sciences, King's College London, London.Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.Department of Health Service and Population Research, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

27973692

Citation

Das-Munshi, J, et al. "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." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 34, no. 7, 2017, pp. 916-924.
Das-Munshi J, Ashworth M, Dewey ME, et al. 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. Diabet Med. 2017;34(7):916-924.
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. (2017). 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. Diabetic Medicine : a Journal of the British Diabetic Association, 34(7), 916-924. https://doi.org/10.1111/dme.13298
Das-Munshi J, et al. 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. Diabet Med. 2017;34(7):916-924. PubMed PMID: 27973692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - 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. AU - Das-Munshi,J, AU - Ashworth,M, AU - Dewey,M E, AU - Gaughran,F, AU - Hull,S, AU - Morgan,C, AU - Nazroo,J, AU - Petersen,I, AU - Schofield,P, AU - Stewart,R, AU - Thornicroft,G, AU - Prince,M J, Y1 - 2017/01/30/ PY - 2016/12/05/accepted PY - 2016/12/16/pubmed PY - 2018/5/2/medline PY - 2016/12/16/entrez SP - 916 EP - 924 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 34 IS - 7 N2 - 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. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/27973692/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_ L2 - https://doi.org/10.1111/dme.13298 DB - PRIME DP - Unbound Medicine ER -