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Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness
It has been argued that persons with severe mental illness (SMI) receive poorer treatment for somatic comorbidities. This study assesses the treatment rates of glucose-lowering and cardiovascular medications among persons with incident type 2 diabetes (T2D) and SMI compared to persons with T2D witho...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263345/ https://www.ncbi.nlm.nih.gov/pubmed/37310947 http://dx.doi.org/10.1371/journal.pone.0287017 |
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author | Bakkedal, Catrine Persson, Frederik Kriegbaum, Margit Andersen, John Sahl Grant, Mia Klinten Mohr, Grimur Høgnason Lind, Bent Struer Andersen, Christen Lykkegaard Christensen, Mikkel Bring Siersma, Volkert Rozing, Maarten Pieter |
author_facet | Bakkedal, Catrine Persson, Frederik Kriegbaum, Margit Andersen, John Sahl Grant, Mia Klinten Mohr, Grimur Høgnason Lind, Bent Struer Andersen, Christen Lykkegaard Christensen, Mikkel Bring Siersma, Volkert Rozing, Maarten Pieter |
author_sort | Bakkedal, Catrine |
collection | PubMed |
description | It has been argued that persons with severe mental illness (SMI) receive poorer treatment for somatic comorbidities. This study assesses the treatment rates of glucose-lowering and cardiovascular medications among persons with incident type 2 diabetes (T2D) and SMI compared to persons with T2D without SMI. We identified persons ≥30 years old with incident diabetes (HbA(1c) ≥ 48 mmol/mol and/or glucose ≥ 11.0 mmol/L) from 2001 through 2015 in the Copenhagen Primary Care Laboratory (CopLab) Database. The SMI group included persons with psychotic, affective, or personality disorders within five years preceding the T2D diagnosis. Using a Poisson regression model, we calculated the adjusted rate ratios (aRR) for the redemption of various glucose-lowering and cardiovascular medications up to ten years after T2D diagnosis. We identified 1,316 persons with T2D and SMI and 41,538 persons with T2D but no SMI. Despite similar glycemic control at diagnosis, persons with SMI redeemed a glucose-lowering medication more often than persons without SMI in the period 0.5–2 years after the T2D diagnosis; for example, the aRR was 1.05 (95% CI 1.00–1.11) in the period 1.5–2 years after the T2D diagnosis. This difference was mainly driven by metformin. In contrast, persons with SMI were less often treated with cardiovascular medications during the first 3 years after T2D diagnosis, e.g., in the period 1.5–2 years after T2D diagnosis, the aRR was 0.96 (95% CI 0.92–0.99). For people with SMI in addition to T2D, metformin is more likely to be used in the initial years after T2D diagnosis, while our results suggest potential room for improvement regarding the use of cardiovascular medications. |
format | Online Article Text |
id | pubmed-10263345 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-102633452023-06-15 Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness Bakkedal, Catrine Persson, Frederik Kriegbaum, Margit Andersen, John Sahl Grant, Mia Klinten Mohr, Grimur Høgnason Lind, Bent Struer Andersen, Christen Lykkegaard Christensen, Mikkel Bring Siersma, Volkert Rozing, Maarten Pieter PLoS One Research Article It has been argued that persons with severe mental illness (SMI) receive poorer treatment for somatic comorbidities. This study assesses the treatment rates of glucose-lowering and cardiovascular medications among persons with incident type 2 diabetes (T2D) and SMI compared to persons with T2D without SMI. We identified persons ≥30 years old with incident diabetes (HbA(1c) ≥ 48 mmol/mol and/or glucose ≥ 11.0 mmol/L) from 2001 through 2015 in the Copenhagen Primary Care Laboratory (CopLab) Database. The SMI group included persons with psychotic, affective, or personality disorders within five years preceding the T2D diagnosis. Using a Poisson regression model, we calculated the adjusted rate ratios (aRR) for the redemption of various glucose-lowering and cardiovascular medications up to ten years after T2D diagnosis. We identified 1,316 persons with T2D and SMI and 41,538 persons with T2D but no SMI. Despite similar glycemic control at diagnosis, persons with SMI redeemed a glucose-lowering medication more often than persons without SMI in the period 0.5–2 years after the T2D diagnosis; for example, the aRR was 1.05 (95% CI 1.00–1.11) in the period 1.5–2 years after the T2D diagnosis. This difference was mainly driven by metformin. In contrast, persons with SMI were less often treated with cardiovascular medications during the first 3 years after T2D diagnosis, e.g., in the period 1.5–2 years after T2D diagnosis, the aRR was 0.96 (95% CI 0.92–0.99). For people with SMI in addition to T2D, metformin is more likely to be used in the initial years after T2D diagnosis, while our results suggest potential room for improvement regarding the use of cardiovascular medications. Public Library of Science 2023-06-13 /pmc/articles/PMC10263345/ /pubmed/37310947 http://dx.doi.org/10.1371/journal.pone.0287017 Text en © 2023 Bakkedal et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Bakkedal, Catrine Persson, Frederik Kriegbaum, Margit Andersen, John Sahl Grant, Mia Klinten Mohr, Grimur Høgnason Lind, Bent Struer Andersen, Christen Lykkegaard Christensen, Mikkel Bring Siersma, Volkert Rozing, Maarten Pieter Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title | Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title_full | Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title_fullStr | Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title_full_unstemmed | Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title_short | Diabetes treatment for persons with severe mental illness: A registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
title_sort | diabetes treatment for persons with severe mental illness: a registry-based cohort study to explore medication treatment differences for persons with type 2 diabetes with and without severe mental illness |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10263345/ https://www.ncbi.nlm.nih.gov/pubmed/37310947 http://dx.doi.org/10.1371/journal.pone.0287017 |
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