True or false? The rates of T2DM in people with SMI are up to 5 times higher vs the general population.
Research suggests that people with severe mental illnesses (SMI) are at increased risk for T2DM and have poorer health outcomes vs those without a psychiatric diagnosis. How does one illness affect the other? What are the proposed links between the 2 diagnoses? Think through the 9 questions in the slide show above, all based on recent studies. Some of the answers may come as a surprise.
Question 2. True or false? The rates of T2DM in people with SMI are up to 5 times higher vs the general population.
Answer: B. False. The rates of T2DM in people with SMI are 2-3 times higher vs the general population.1
Question 3. Among racial minorities with SMI, T2DM prevalence was highest (vs whites) among Hispanics, African Americans, Asian Pacific Islanders, or American Indian/Alaskan native?
Answer: A. Hispanics. T2DM prevalence is highest among Hispanics with SMI (36.9%) vs whites (25.1%).2
Question 4. Which of the above antipsychotic drugs is linked to the highest increase in total body fat in children/teens?
Answer: C. Olanzapine. Children and teens taking olanzapine had a 4.12% increase in total body fat vs risperidone (1.18%) and aripiprazole (1.66%).3
Question 5. Among people with major depressive disorder, how much higher is the prevalence of T2DM vs the general population?
Question 7. Which group of people do patients with SMI find to be the most helpful to them in managing their T2DM?
Answer: D. Primary care physicians. 69% of T2DM patients agree that their primary care physician is the most helpful to them in managing T2DM vs diabetes specialists (49%), mental health professionals (35%), and family and friends (30%).4
Question 8. Which aspect of T2DM self-care do most patients with SMI find the most difficult to manage?
Answer: A. Exercising. In a study of 77 T2DM patients with SMI, 37.7% of patients found exercising for at least 30 minutes/day for 5 days/week to be the most difficult aspect of T2DM management.4
Question 9. Which of the above behaviors do T2DM patients with SMI perform least often during the week?
Answer: D. Checking their feet. Patients reported checking their feet only on 1.7 days out of the week. Eating a general diet is the most frequently performed at 4.1 days out of the week.4
1. Whicher CA, Price HC, Holt RIG, et al. Mechanisms in endocrinology: Antipsychotic medication and type 2 diabetes and impaired glucose regulation. Eur J Endocrinol. 2018;178:R245-R258.
2. Mangurian CV, Schillinger D, Newcomer JW, et al. Diabetes and prediabetes prevalence by race and ethnicity among people with severe mental illness. Diabetes Care. 2018;41:e119-e120.
3. Nicol GE, Yingling MD, Flavin KS, et al. Metabolic effects of antipsychotics on adiposity and insulin sensitivity in youths: A randomized clinical trial. JAMA Psychiatry. 2018.
4. Mulligan K, McBain H, Lamontagne-Godwin F, et al. Barriers to effective diabetes management - a survey of people with severe mental illness. BMC Psychiatry 2018;18:165.