Glucose, cholesterol and blood pressure in type II diabetes: a longitudinal observational study comparing patients with and without severe mental illness

TY - JOUR

T1 - Glucose, cholesterol and blood pressure in type II diabetes

T2 - a longitudinal observational study comparing patients with and without severe mental illness

AU - Smith, Robert

AU - Han, Lu

AU - Ali, Shehzad

AU - Prady, Stephanie L

AU - Taylor, Joanne

AU - Hughes, Tom

AU - Ajjan, Ramzi A

AU - Siddiqi, Najma

AU - Doran, Tim

N1 - © 2019 John Wiley & Sons Ltd. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2019/7/31

Y1 - 2019/7/31

N2 - INTRODUCTION: Patients with both severe mental illness (SMI) and type II diabetes (T2DM) have lower life expectancy than patients with T2DM alone, partly due to poor control of cardiovascular risk factors in comorbid patients.AIM: To compare levels of cholesterol, HbA1c and blood pressure in T2DM patients with and without SMI.METHOD: We analysed longitudinal clinical records of 30,353 people with T2DM (657 with SMI;29,696 controls without SMI) between 2001 and 2013 using the Clinical Practice Research Datalink (CPRD). We used mixed effects regression models to compare cardiovascular risk factors between SMI and controls.RESULTS: Patients with SMI had lower mean systolic blood pressure (SBP) (β -2.49; SE=0.45 P=<0.01) and were more likely to have extreme (high and low) values of HbA1c and SBP (OR 1.38, 95%CI: 1.16,1.64 and 1.76:1.40,2.21 respectively).DISCUSSION: People with T2DM and SMI have similar average values of cardiovascular risk factors to people with T2DM alone but are more likely to have values of HbA1c and SBP indicating increased risk of adverse clinical outcomes.IMPLICATIONS FOR PRACTICE: Improved management of cardiovascular risk factors in general, glycaemic control in particular, is central to addressing the increased risk of adverse outcomes in people with both SMI and T2DM. This article is protected by copyright. All rights reserved.

AB - INTRODUCTION: Patients with both severe mental illness (SMI) and type II diabetes (T2DM) have lower life expectancy than patients with T2DM alone, partly due to poor control of cardiovascular risk factors in comorbid patients.AIM: To compare levels of cholesterol, HbA1c and blood pressure in T2DM patients with and without SMI.METHOD: We analysed longitudinal clinical records of 30,353 people with T2DM (657 with SMI;29,696 controls without SMI) between 2001 and 2013 using the Clinical Practice Research Datalink (CPRD). We used mixed effects regression models to compare cardiovascular risk factors between SMI and controls.RESULTS: Patients with SMI had lower mean systolic blood pressure (SBP) (β -2.49; SE=0.45 P=<0.01) and were more likely to have extreme (high and low) values of HbA1c and SBP (OR 1.38, 95%CI: 1.16,1.64 and 1.76:1.40,2.21 respectively).DISCUSSION: People with T2DM and SMI have similar average values of cardiovascular risk factors to people with T2DM alone but are more likely to have values of HbA1c and SBP indicating increased risk of adverse clinical outcomes.IMPLICATIONS FOR PRACTICE: Improved management of cardiovascular risk factors in general, glycaemic control in particular, is central to addressing the increased risk of adverse outcomes in people with both SMI and T2DM. This article is protected by copyright. All rights reserved.

KW - epidemiology

KW - physical health

KW - primary care

UR - http://www.scopus.com/inward/record.url?scp=85070079246&partnerID=8YFLogxK

U2 - 10.1111/jpm.12546

DO - 10.1111/jpm.12546

M3 - Article

C2 - 31287193

SN - 1351-0126

JO - Journal of psychiatric and mental health nursing

JF - Journal of psychiatric and mental health nursing

ER -