Diabetics with mental disorders at increased risk for diabetic complications

Diabetics with mental disorders do not have as good blood sugar control as diabetics without mental illness and are more likely to suffer one or more diabetes complication including loss of kidney function, loss of sensation in the feet, and visual problems (including blindness) than diabetics without mental illness, according to a study published in the December issue of Medical Care.

“This study provides a solid foundation for further work into understanding whether provider, patient or system factors can be modified to ensure better overall care of diabetic patients with mental disorders,.” said Caroline Carney, M.D., M.Sc., associate professor of psychiatry and medicine at the Indiana University School of Medicine and a research scientist at the Regenstrief Institute, Inc. Dr. Carney is the senior author of the study which looked at insurance claims data from more than 26,000 diabetic adults between the ages of 18 and 64 living in Iowa.

“Even when we controlled for utilization of healthcare services, diabetics with mental disorders did less well at controlling their diabetes and had more complications than diabetics who had no mental health complaints,” said Dr. Carney.

The researchers found that diabetics with mental disorders were more likely to be young, female, and urban residents and to make greater use of healthcare services than the diabetics without mental illness. Mental disorders presented by the diabetics in the study include mood, adjustment, anxiety, cognitive, psychotic, substance abuse and sexual disorders.

“These findings underscore the need for physicians to treat the whole patient – not simply the mental disorders or the physical complaints,” said Dr. Carney who is both an internist and a psychiatrist.