Elevated Risk of Developing Type 2 Diabetes in People with Psychiatric Disorders
Journal of Diabetes and its Complications: August 2023
Nearly one out of three individuals will develop a
psychiatric disorder during their life. Severe psychiatric disorders are
associated with higher mortality rates, with 10–20 life-years lost compared to
individuals without a severe psychiatric disorder
Several psychiatric disorders are linked with an increased
risk of developing type 2 diabetes (T2D), but the mediating mechanisms are
unclear. Authors aimed to investigate health behaviors, obesity, psychotropic
medication use, and comorbidity as potential mediating mechanisms explaining
these associations.
TAKE-HOME MESSAGE
This population-based survey
investigated health behaviors (daily smoking, high alcohol consumption,
physical inactivity, unhealthy diet, and sleep problems), obesity, psychotropic
medication (antipsychotic medication and antidepressant medication) use, and
comorbidity as mediating mechanisms explaining the associations between
psychiatric disorders and an increased risk of type 2 diabetes.
The risk of developing type 2
diabetes was higher in individuals with substance use disorders, schizophrenia,
mood disorders, eating disorders, or personality disorders. The largest
proportional mediating effect on the association was the use of antidepressant
medications.
The use of antidepressant medications
was the largest contributor to the association between psychiatric disorders
and incident type 2 diabetes.
Conclusions
For all the psychiatric disorders significantly associated
with incident T2D, authors found that use of psychotropic medication
(antipsychotic and antidepressant medication) contributed more to the
associations with incident T2D than health behaviors.
More specifically, the use of antidepressant medication had
the largest contribution to the associations between psychiatric disorders and
incident T2D.
Daily smoking, physical inactivity, sleep problems, obesity, use of antipsychotic medication, and psychiatric comorbidity also played a significant role, whereas high alcohol consumption had a small protective effect on the associations, and unhealthy diet and somatic comorbidity did not mediate the associations.
Doctors Liked to Read More
AIMS
Several psychiatric disorders are linked with an increased
risk of developing type 2 diabetes (T2D), but the mediating mechanisms are
unclear. We aimed to investigate health behaviors, obesity, psychotropic
medication use, and comorbidity as potential mediating mechanisms explaining these
associations.
METHODS
We combined data from a large population-based survey with
register-based data and followed a sample of 250,013 Danes (≥16 years) for up
to 8.9 years. We conducted mediation analyses investigating 10 potential
mediators of the associations between psychiatric disorders and incident T2D.
RESULTS
Individuals with a substance use disorder, schizophrenia,
mood disorder, neurotic disorder, eating disorder, or a personality disorder
had a significantly higher risk of developing T2D. Organic disorders,
intellectual disabilities, developmental and behavioral disorders were not
associated with T2D-risk. For all psychiatric disorders significantly
associated with T2D, the use of antidepressant medication had the largest
proportional mediating effect on the association (13–32 %).
CONCLUSIONS
Use of antidepressant medication had the largest contribution
to the associations between psychiatric disorders and incident T2D. Future
epidemiological studies and prevention studies should focus on optimizing the
use of antidepressant medication with minimal side effects, and the promotion
of health behaviors in individuals with a psychiatric disorder to prevent T2D.
Comments
You must login to write comment