Diabetes Screening among Antipsychotic-Treated Adults with Severe Mental Illness in an Integrated Delivery System: A Retrospective Cohort Study

Journal of General Internal Medicine
Christina MangurianJulie Schmittdiel

Abstract

Severe mental illness (SMI) is associated with increased risk for type 2 diabetes, partly due to adverse metabolic effects of antipsychotic medications. In public health care settings, annual screening rates are 30%. We measured adherence to national diabetes screening guidelines for patients taking antipsychotic medications. To estimate diabetes screening prevalence among patients with SMI within an integrated health care system, and to assess characteristics associated with lack of screening. Retrospective cohort study. Antipsychotic-treated adults with SMI. We excluded participants with known diabetes. Primary outcome was screening via fasting glucose test or hemoglobin A1c during a 1-year period. In 2014, 16,754 patients with SMI diagnoses were receiving antipsychotics. Seventy-four percent of these patients' providers ordered diabetes screening tests that year, but only 55% (9247/16,754) received screening. When the observation time frame was extended to 2 years, 73% (12,250/16,754) were screened. Adjusting for sex and race/ethnicity, young adults (aged 18-29 years) were less likely to receive screening than older age groups [adjusted RR (aRR) 1.23-1.57, p < 0.0001]. Compared to whites, screening was more common for Asians...Continue Reading

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Citations

Jun 15, 2018·Diabetes Care·Christina V MangurianJulie A Schmittdiel
Nov 11, 2019·Journal of General Internal Medicine·Christina MangurianJulie Schmittdiel
Aug 24, 2020·The Psychiatric Quarterly·Maria E GarciaChristina Mangurian
Sep 11, 2019·European Psychiatry : the Journal of the Association of European Psychiatrists·Marina GarrigaMerete Osler
Nov 1, 2020·Nature Reviews. Cardiology·René Ernst NielsenSvend Eggert Jensen

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