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

Jayati Das-Munshi*, Mark Ashworth, Michael Edward Dewey, Fiona Patricia Gaughran, Sally Hull, Craig Morgan, James Nazroo, Irene Petersen, Peter Schofield, Robert James Stewart, Graham J Thornicroft, Martin J. Prince

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)
185 Downloads (Pure)

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.

Original languageEnglish
JournalDiabetic Medicine
Early online date14 Dec 2016
DOIs
Publication statusE-pub ahead of print - 14 Dec 2016

Fingerprint

Dive into the research topics of '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'. Together they form a unique fingerprint.

Cite this