medwireNews: The prevalence of type 2 diabetes is high in people with psychiatric disorders and often substantially exceeds global population-based estimates of 6% to 9%, indicates an umbrella review of data from more than 200 observational studies.
Nanna Lindekilde (University of Southern Denmark, Odense) and colleagues say that although previous research has often focused on schizophrenia and depression, their findings “suggest that the prevalence of type 2 diabetes is also high in several other psychiatric disorders, emphasising the need for future studies that cover the full range of psychiatric disorders.”
The analysis included data from 32 systematic reviews of 245 unique primary observational studies investigating the prevalence of type 2 diabetes in adults with a psychiatric disorder.
Lindekilde and team found that, overall, the prevalence estimates for type 2 diabetes in people with clinically diagnosed psychiatric disorders ranged from 1.3% to 66.0%. However, when only including the 12 systematic reviews with a low risk for bias, the range was 5.1% to 22.3%.
When they then carried out meta-analyses for 10 different categories of psychiatric disorder, each including between six and 153 unique primary studies, they observed that the prevalence of type 2 diabetes was highest among people with a sleep disorder, at 39.7%.
This was followed by those with a binge eating disorder (20.7%), a substance use disorder (15.6%), an anxiety disorder (13.7%), bipolar disorder (11.4%), and psychosis (11.1%).
People with schizophrenia had a type 2 diabetes prevalence of 10.1%, while the rates were 10.0%, 9.1%, and 8.1% in those with a mixed group of psychiatric disorders, depression, and an intellectual disability, respectively.
The researchers note that there was a “high level of between-study heterogeneity” and “substantial publication bias” in meta-analyses for several categories of psychiatric disorder. They say this means that “more refined comparisons should be made between prevalence estimates in the future to better account for differences in population groups, study settings and the broad range of years as well as methods used to ascertain type 2 diabetes.”
Writing in Diabetologia, Lindekilde and co-authors conclude: “Reliable information about prevalence and a better understanding of biological and behavioural factors driving increased prevalence of type 2 diabetes in people with psychiatric disorders will be crucial to developing cost-effective strategies for the management of type 2 diabetes in people with psychiatric disorders.”
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