Severe mental illness and the risk of diabetes complications. A nationwide register-based cohort study
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Severe mental illness and the risk of diabetes complications. A nationwide register-based cohort study. / Scheuer, Stine H; Kosjerina, Vanja; Lindekilde, Nanna; Pouwer, Frans; Carstensen, Bendix; Jørgensen, Marit E.; Benros, Michael E; Andersen, Gregers S.
In: The Journal of clinical endocrinology and metabolism, Vol. 107, No. 8, 2022, p. e3504–e3514.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Severe mental illness and the risk of diabetes complications. A nationwide register-based cohort study
AU - Scheuer, Stine H
AU - Kosjerina, Vanja
AU - Lindekilde, Nanna
AU - Pouwer, Frans
AU - Carstensen, Bendix
AU - Jørgensen, Marit E.
AU - Benros, Michael E
AU - Andersen, Gregers S.
N1 - © The Author(s) 2022. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
PY - 2022
Y1 - 2022
N2 - CONTEXT: Persons with severe mental illness (SMI) are at increased risk to develop type 2 diabetes.OBJECTIVE: It is unclear whether persons with diabetes and SMI are also at increased risk of diabetes complications and the potential age-specific differences in development of these.DESIGN, SETTING, AND PARTICIPANTS: Utilizing nationwide register data we followed the entire Danish population with type 2 diabetes from 01.01.1996 to 31.12.2018. Exposure was SMI (schizophrenia, bipolar or depression disorders). Outcome was diabetes complications (nephropathy, retinopathy, lower limp amputations, and cardiovascular disease). We applied Poisson regression models to estimate overall incidence rate ratios (IRRs) and age-specific incidence rates (IRs) and IRRs of first event of each complication in persons with SMI compared to persons without SMI. The models were adjusted for sex, age, diabetes duration, calendar year, education, and migration status.RESULTS: We followed 371,625 persons with type 2 diabetes, of which 30,102 had coexisting diagnosed SMI. Persons with SMI had a higher IR of nephropathy (IRR: 1.15; 95% CI: 1.12-1.18), amputations (IRR: 1.15; 95% CI: 1.04-1.28), and cardiovascular disease (men: IRR: 1.10; 95% CI: 1.06-1.15, women: IRR: 1.18; 95% CI: 1.13-1.22) but a lower IR of retinopathy (IRR: 0.75; 95% CI: 0.70-0.81) when compared to persons without SMI, after adjustment for confounders. For all complications except amputations, the difference in IR was highest in the younger age groups.CONCLUSIONS: Persons with type 2 diabetes and SMI had a higher risk and an earlier onset of several diabetes complications diagnosis, emphasizing focusing on improving diabetes management in younger age groups with SMI.
AB - CONTEXT: Persons with severe mental illness (SMI) are at increased risk to develop type 2 diabetes.OBJECTIVE: It is unclear whether persons with diabetes and SMI are also at increased risk of diabetes complications and the potential age-specific differences in development of these.DESIGN, SETTING, AND PARTICIPANTS: Utilizing nationwide register data we followed the entire Danish population with type 2 diabetes from 01.01.1996 to 31.12.2018. Exposure was SMI (schizophrenia, bipolar or depression disorders). Outcome was diabetes complications (nephropathy, retinopathy, lower limp amputations, and cardiovascular disease). We applied Poisson regression models to estimate overall incidence rate ratios (IRRs) and age-specific incidence rates (IRs) and IRRs of first event of each complication in persons with SMI compared to persons without SMI. The models were adjusted for sex, age, diabetes duration, calendar year, education, and migration status.RESULTS: We followed 371,625 persons with type 2 diabetes, of which 30,102 had coexisting diagnosed SMI. Persons with SMI had a higher IR of nephropathy (IRR: 1.15; 95% CI: 1.12-1.18), amputations (IRR: 1.15; 95% CI: 1.04-1.28), and cardiovascular disease (men: IRR: 1.10; 95% CI: 1.06-1.15, women: IRR: 1.18; 95% CI: 1.13-1.22) but a lower IR of retinopathy (IRR: 0.75; 95% CI: 0.70-0.81) when compared to persons without SMI, after adjustment for confounders. For all complications except amputations, the difference in IR was highest in the younger age groups.CONCLUSIONS: Persons with type 2 diabetes and SMI had a higher risk and an earlier onset of several diabetes complications diagnosis, emphasizing focusing on improving diabetes management in younger age groups with SMI.
U2 - 10.1210/clinem/dgac204
DO - 10.1210/clinem/dgac204
M3 - Journal article
C2 - 35359003
VL - 107
SP - e3504–e3514
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 8
ER -
ID: 306466363