title: Clinical Characteristics of Diabetes Mellitus and Suicide Risk.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a chronic illness with impaired health-related quality of life and a high risk of psychiatric disorders. We carried out a systematic review analyzing the relationship between DM and suicide by providing a qualitative data synthesis of the studies.
  
  
  METHODS
  We conducted, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search of the literature in PubMed, Scopus, ISI Web of Science, PsycINFO, Google Scholar, and ScienceDirect. Search terms were "suicid*" combined with the Boolean "AND" operator with "diabetes."
  
  
  RESULTS
  The initial search identified 568 citations. A total of 17 research reports met the predefined inclusion criteria and were analyzed. DM was found to be significantly associated with a marked increase in suicidal behaviors and suicidal ideation (SI), especially in patients with depressive symptoms. Insulin therapy, DM of long duration, and unsatisfactory glycemic control were identified as risk factors for SI in Type 1 (T1DM) and Type 2 (T2DM).
  
  
  CONCLUSIONS
  Health-care professionals need to be aware of the higher suicidal risk in patient subgroups based on the clinical characteristics of DM; thus, patients with these characteristics warrant special attention. In this regard, clinical management should include efforts to manage emotional distress in DM care.
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Conti
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Mennitto
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Di Francesco
authors.affiliation: Department of Medicine and Aging, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fraticelli
authors.affiliation: Department of Medicine and Aging, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Ester
authors.initials: E
authors.lastname: Vitacolonna
authors.affiliation: Department of Psychological, Health, and Territorial Sciences, University "G. d'Annunzio" of Chieti-Pescara , Chieti , Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Fulcheri
keywords: depression; diabetes mellitus; suicidal behavior; suicidal ideation; suicide attempt