A comparison of type 2 diabetes outcomes among persons with and without severe mental illnesses.
OBJECTIVE
Type 2 diabetes is an important comorbid medical condition associated with schizophrenia. The objective of this study was to compare glycosylated hemoglobin (HbA(1c)) levels of patients who had type 2 diabetes and schizophrenia with those of patients who had type 2 diabetes and major mood disorders and those who had type 2 diabetes but who did not have severe mental illness.


METHODS
A sample of 300 patients with type 2 diabetes was recruited from community mental health centers in the greater Baltimore region and nearby primary care clinics. Of these, 100 had schizophrenia, 101 had a major mood disorder, and 99 had no identified severe mental illness. HbA(1c), the main outcome measure, was compared between the group with schizophrenia and the other two groups.


RESULTS
All three groups had HbA(1c) values above recommended levels. HbA(1c) levels were significantly lower among patients with schizophrenia than among patients who did not have severe mental illness but were not significantly different from those of patients who had major mood disorders. Patients for whom olanzapine was prescribed had higher HbA(1c) levels than those for whom other antipsychotic agents were prescribed.


CONCLUSIONS
All three groups of patients require improved diabetes treatment to achieve acceptable HbA(1c) levels. There may be previously unrecognized benefits for diabetes management among persons with severe mental illnesses who are receiving regular mental heath care, but these individuals may also have risk factors that can influence diabetes outcomes and HbA(1c) levels.
Dixon
Lisa B
LB
Department of Psychiatry, University of Maryland School of Medicine, 685 West Baltimore Street, MSTF/300, Baltimore, Maryland 21201, USA. ldixon@psych.umaryland.edu
Kreyenbuhl
Julie A
JA
Dickerson
Faith B
FB
Donner
Thomas W
TW
Brown
Clayton H
CH
Wohlheiter
Karen
K
Wolheiter
Karen
K
Postrado
Leticia
L
Goldberg
Richard W
RW
Fang
LiJuan
L
Marano
Christopher
C
Messias
Erick
E
D001569:Benzodiazepines / Q000627:therapeutic use*; D015992:Body Mass Index; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology*; D008875:Middle Aged; D000077152:Olanzapine; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D012720:Severity of Illness Index
D001569:Benzodiazepines; D006442:Glycated Hemoglobin; D000077152:Olanzapine