Spotting the Treatment Gap in Diabetes Screening

Diabetes screening may be lacking among adults with severe mental illness

/ Author:  / Reviewed by: Beth Bolt, RPh

(RxWiki News) Patients with severe mental illness face an increased risk for diabetes. And new evidence suggests there may be room for improvement when it comes to screening these patients for the condition.

A new study from the University of California at San Francisco (UCSF) found that many patients with severe mental illness, such as those with bipolar disorder or schizophrenia, were not screened for diabetes by the California public mental health care system — despite current recommendations on screening from the American Diabetes Association (ADA).

This finding may be cause for concern considering that severe mental illness has been linked to an increased risk of type 2 diabetes, and antipsychotic drugs can contribute to this risk. That's why the ADA recommends annual diabetes screening for all patients treated with antipsychotics.

Type 2 diabetes is a chronic metabolic condition that affects the way the body processes blood sugar.

For this study, a team of researchers led by Christina Mangurian, MD, an associate professor of clinical psychiatry at UCSF, looked at data from the California Medicaid and the California Client and Service Information System for two periods: 2009 and October 2010 to September 2011.

All of these patients had been diagnosed with severe mental illness by a psychiatrist and were prescribed an antipsychotic at least once during both periods.

Of the 50,915 adult patients studied, only about 30 percent received diabetes-specific screening during these periods.

About 39 percent received nonspecific diabetes screening, while 31 percent received no screening at all.

Patients who had at least one primary care visit in addition to mental health services were more than twice as likely as those who did not to be screened for diabetes.

Adults with severe mental illness are estimated to die 25 years earlier than the general population on average, according to the authors of this study. This statistic is largely due to premature heart disease. Diabetes can dramatically increase the risk of various cardiovascular problems.

This article was published online Nov. 9 in the journal JAMA Internal Medicine.

The National Institutes of Health funded this research.

Study author Dr. John W. Newcomer served on the data safety monitoring board for Amgen, Bristol-Myers Squibb and Merck. Study author Dr. Penelope Knapp served as medical director for the California Department of Mental Health during this study.

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Review Date: 
November 9, 2015
Last Updated:
November 10, 2015