People with serious mental illness have higher rates of type 2 diabetes

Sep 1 2005

People with serious mental illness have higher rates of type 2 diabetes than the general population, yet their knowledge of diabetes was generally poor and significantly lower than people without mental illness, according to a new study.

This finding “suggests that more education about type 2 diabetes is needed for those suffering from serious mental illnesses,” according to Faith Dickerson, lead author of the study in the latest issue of the journal Psychosomatics.

The research team - from the Sheppard Pratt Health System and the University of Maryland School of Medicine in Baltimore - looked at 201 people with both diabetes and either schizophrenia or a major mood disorder.

The study included 100 people with schizophrenia and 101 with major mood disorders -- 97 males, 99 whites, 90 African-Americans, and 12 members of other racial groups. The group’s knowledge of diabetes was tested, and its adherence to self-care activities was measured. These results were compared with those from a non-mentally-ill group that had been previously tested.

Both schizophrenia and major mood disorders may impair cognitive function. They may disrupt normal attentiveness, learning and motivation, attributes considered essential to the self-management of type 2 diabetes.

The researcher found indications that diabetes knowledge may increase if people who also suffer from serious mental illness are instructed specifically about diabetes. Well-structured and very focused educational efforts may improve the their ability to manage their diabetes.

Self-management of type 2 diabetes is essential to prevent future complications. The authors say the relatively high rate of diabetes within this group may contribute to the excess mortality the group experiences.

It is not clear why people with these serious mental illness are more prone to develop type 2 diabetes. The report notes, however, that there is a high prevalence of obesity among those with these disorders and that possible links are being examined between the use of second-generation antipsychotic medicines and the incidence of type 2 diabetes.

Type 2 diabetes affects about 4 percent of the U.S. population. The condition, which impairs the body’s ability to process glucose, can be managed by exercise and dietary changes aimed at losing weight, along with oral medications. Management of the disease also may require daily monitoring of blood glucose levels and insulin injections.

Robert A. Rizza, M.D., president of the American Diabetes Association and a professor at the Mayo Clinic College of Medicine, says the report “shows that education indeed makes a difference and that’s great as a first step.

“What we need now,” Rizza adds, “is more study to show that education can really alter outcomes” and improve the lives of people with cognitive problems and type 2 diabetes.