Undoing Descartes: integrating diabetes care for those with mental illness

2011 ◽  
Vol 28 (6) ◽  
pp. 270-275 ◽  
Author(s):  
RIG Holt
Keyword(s):  
Mental Illness ◽  
Diabetes Care

Quality of Diabetes Care Among Adults With Serious Mental Illness

2007 ◽  
Vol 58 (4) ◽  
pp. 536-543 ◽  
Author(s):  
Richard W. Goldberg ◽  
Julie A. Kreyenbuhl ◽  
Deborah R. Medoff ◽  
Faith B. Dickerson ◽  
Karen Wohlheiter ◽  
...  
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Diabetes Care ◽  
Quality Of Diabetes Care

scholarly journals Diabetes Prevalence and Risk Factors in Patients With Chronic Mental Illness on Second-Generation Antipsychotics

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A410-A411
Author(s):  
Priya Sahay ◽  
Simran Shikh ◽  
Carol Akinbowale ◽  
Salman Meher Azim ◽  
J Steven Lamberti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mental Illness ◽  
Plasma Glucose ◽  
Diabetes Care ◽  
Second Generation ◽  
Dietary Habits ◽  
American Association ◽  
Diabetic Patients ◽  
Chronic Mental Illness ◽  
Model Assessment

Abstract The rates of obesity and type 2 diabetes (T2D) are much higher in patients with chronic mental illness compared to the general population1. Second-generation antipsychotic medications (SGA) are clearly contributory to these adverse metabolic phenotypes2. Thus, annual monitoring of fasting plasma glucose (FPG) levels is recommended to screen for T2D in patients on SGA3. Of note, FPG, and also HbA1c, have poor sensitivities in detecting T2D early, with nearly 50% of cases being missed using either of the above tests when compared to oral Glucose Tolerance Testing (oGTT,4). We thus screened patients with schizophrenia, schizoaffective or bipolar disorder on SGA per oGTT. We hypothesized that we would identify more patients with T2D per oGTT compared to FPG or HbA1c testing alone. To identify risk factors for T2D, we also assessed BMI, waist/hip ratio, blood pressure, dietary habits (UKDDQ = UK Diabetes and Diet Questionnaire), physical activity records (3d pedometer records), measures of psychopathology, cognition (PHQ-9 = Patient Health Questionnaire, SLUMS = Saint Louis University Mental Status exam) as well as HOMA IR (Homeostatic Model Assessment of Insulin Resistance), Matsuda index and lipid profile. Data were analyzed using SPSS, comparing normal and prediabetic patients to patients with T2D (per oGTT criteria). Thus far, we screened 22 patients per oGTT and newly identified 5 patients with T2D (23%), only one patient had T2D per HbA1c criterion, 4 were identified per elevated FPG, 3 patients had elevated 2h plasma glucose levels. Patients with T2D had significantly lower Matsuda indices (p<0.0001); trends towards higher HOMA IR and waist/hip ratios were observed in diabetic compared to non-diabetic patients (p=0.08). Patients with T2D tended to be heavier, had worse dietary habits (higher UKDDQ scores), and surprisingly were less depressed (lower PHQ-9 scores) than non-diabetic patients (p<0.25). In conclusion, oGTT is more sensitive in identifying patients with T2D early compared to FPG or HbA1c alone. Matsuda indices, HOMA IR and waist/hip ratios may serve as additional markers to distinguish non-diabetic from diabetic patients. Since metabolic syndrome and diabetes are all risk factors for an increased cardiovascular mortality in patients with chronic mental illness, identifying and treating T2D early and aggressively should be primary goals of care in this high-risk patient population. References:1 Lean ME, Pajonk FG. Diabetes Care. 2003 May;26(5):1597–605.2 Allison DB, Mentore JL, Heo M, et al. Am J Psychiatry 1999 Nov;156(11):1686–1696.3 American Diabetes Association; American Psychiatric Association; American Association of Clinical Endocrinologists; North American Association for the Study of Obesity. Diabetes Care. 2004 Feb;27(2):596–601.4 Cowie CC, Rust KF, Byrd-Holt DD, et al. Diabetes Care 2010 Mar;33(3):562–568.

scholarly journals Management of type 2 diabetes mellitus in people with severe mental illness: an online cross-sectional survey of healthcare professionals

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019400 ◽  
Author(s):  
Hayley McBain ◽  
Frederique Lamontagne-Godwin ◽  
Mark Haddad ◽  
Alan Simpson ◽  
Jacqui Chapman ◽  
...  
Keyword(s):  
Mental Health ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Mental Illness ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Care ◽  
Health Professionals ◽  
Healthcare Professionals ◽  
Cross Sectional

ObjectivesTo establish healthcare professionals’ (HCPs) views about clinical roles, and the barriers and enablers to delivery of diabetes care for people with severe mental illness (SMI).DesignCross-sectional, postal and online survey.SettingTrusts within the National Health Service, mental health and diabetes charities, and professional bodies.ParticipantsHCPs who care for people with type 2 diabetes mellitus (T2DM) and/or SMI in the UK.Primary and secondary outcome measuresThe barriers, enablers and experiences of delivering T2DM care for people with SMI, informed by the Theoretical Domains Framework.ResultsRespondents were 273 HCPs, primarily mental health nurses (33.7%) and psychiatrists (32.2%). Only 25% of respondents had received training in managing T2DM in people with SMI. Univariate analysis found that mental health professionals felt responsible for significantly fewer recommended diabetes care standards than physical health professionals (P<0.001). For those seeing diabetes care as part of their role, the significant barriers to its delivery in the multiple regression analyses were a lack of knowledge (P=0.003); a need for training in communication and negotiation skills (P=0.04); a lack of optimism about the health of their clients (P=0.04) and their ability to manage T2DM in people with SMI (P=0.003); the threat of being disciplined (P=0.02); fear of working with people with a mental health condition (P=0.01); a lack of service user engagement (P=0.006); and a need for incentives (P=0.04). The significant enablers were an understanding of the need to tailor treatments (P=0.04) and goals (P=0.02) for people with SMI.ConclusionsThis survey indicates that despite current guidelines, diabetes care in mental health settings remains peripheral. Even when diabetes care is perceived as part of an HCP’s role, various individual and organisational barriers to delivering recommended T2DM care standards to people with SMI are experienced.

scholarly journals Quality of Diabetes Care for Underserved Patients With and Without Mental Illness: Site of Care Matters

2010 ◽  
Vol 61 (12) ◽  
pp. 1204-1210 ◽  
Author(s):  
Jacqueline Lynn Green ◽  
Julie A. Gazmararian ◽  
Kimberly J. Rask ◽  
Benjamin G. Druss
Keyword(s):  
Mental Illness ◽  
Diabetes Care ◽  
Underserved Patients ◽  
Quality Of Diabetes Care

scholarly journals Clinical Application of Patient-Centered Diabetes Care for People With Serious Mental Illness

2017 ◽  
Vol 35 (5) ◽  
pp. 313-320 ◽  
Author(s):  
Jay A. Hamm ◽  
Kelly D. Buck ◽  
Jasmine D. Gonzalvo
Keyword(s):  
Mental Illness ◽  
Clinical Application ◽  
Serious Mental Illness ◽  
Diabetes Care ◽  
Patient Centered

Improving diabetes care among patients with severe mental illness: A systematic review of the effect of interventions

2018 ◽  
Vol 12 (4) ◽  
pp. 289-304 ◽  
Author(s):  
A.O. Grøn ◽  
E.-M. Dalsgaard ◽  
A.R. Ribe ◽  
S. Seidu ◽  
G. Mora ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Diabetes Care

scholarly journals Retrospective Analysis of Diabetes Care in California Medicaid Patients with Mental Illness

2009 ◽  
Vol 24 (7) ◽  
pp. 802-808 ◽  
Author(s):  
Jim E. Banta ◽  
Elaine H. Morrato ◽  
Scott W. Lee ◽  
Mark G. Haviland
Keyword(s):  
Mental Illness ◽  
Retrospective Analysis ◽  
Diabetes Care
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