Debra L Foley1, Andrew Mackinnon2, Vera A Morgan3, Gerald F Watts4, David J Castle5, Anna Waterreus3, Cherrie A Galletly6. 1. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia; 2. Orygen, The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Science, University of Melbourne, Melbourne, Australia; Andrew.Mackinnon@unimelb.edu.au. 3. Neuropsychiatric Epidemiology Research Unit, School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia; 4. Lipid Disorders Clinic, Metabolic Research Centre and Department of Cardiology, Royal Perth Hospital and School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; 5. St Vincent's Hospital, Melbourne and Department of Psychiatry, University of Melbourne, Melbourne, Australia; 6. Discipline of Psychiatry, University of Adelaide; Ramsay Health Care (SA) Mental Health; Northern Adelaide Local Health Network, Adelaide, Australia.
Abstract
OBJECTIVE: To estimate awareness of pre-diabetes or type 2 diabetes and associated factors in people with psychosis, a known high-risk group. METHODS: Cross sectional analysis of a national sample with psychosis who were aged 18-64 years, gave a fasting blood sample (n = 1155), had pre-diabetes or diabetes based on testing (n = 359) and reported if they knew they had high blood sugar or diabetes at survey (n = 356). Logistic regression was used to identify factors associated with awareness of pre-diabetes or diabetes prior to testing. RESULTS: The prevalence of pre-diabetes (19.0% 219/1153) or type 2 diabetes (12.1%, 140/1153) was 31.1% (359/1153); 45% (160/356) were known prior to testing. Factors associated with detection were higher fasting blood glucose, older age, a perception of poor health, severe obesity, dyslipidaemia or treatment with a lipid regulating drug, a family history of diabetes, Aboriginal or Torres Strait Islander descent, decreased cognitive functioning, regional economic disadvantage, treatment with an antihypertensive drug, and an elevated 5-year risk for cardiovascular disease. The prevalence of undiagnosed pre-diabetes/diabetes was highest in those aged 25-34 years at 34.2%. CONCLUSIONS: Clinical detection of pre-diabetes or diabetes in people with psychosis was strongly dependent on established risk factors for type 2 diabetes in the population but not on current antipsychotic drug treatment or psychiatric case management which should ensure regular screening. Screening must become a clinical priority and should not wait until age 40.
OBJECTIVE: To estimate awareness of pre-diabetes or type 2 diabetes and associated factors in people with psychosis, a known high-risk group. METHODS: Cross sectional analysis of a national sample with psychosis who were aged 18-64 years, gave a fasting blood sample (n = 1155), had pre-diabetes or diabetes based on testing (n = 359) and reported if they knew they had high blood sugar or diabetes at survey (n = 356). Logistic regression was used to identify factors associated with awareness of pre-diabetes or diabetes prior to testing. RESULTS: The prevalence of pre-diabetes (19.0% 219/1153) or type 2 diabetes (12.1%, 140/1153) was 31.1% (359/1153); 45% (160/356) were known prior to testing. Factors associated with detection were higher fasting blood glucose, older age, a perception of poor health, severe obesity, dyslipidaemia or treatment with a lipid regulating drug, a family history of diabetes, Aboriginal or Torres Strait Islander descent, decreased cognitive functioning, regional economic disadvantage, treatment with an antihypertensive drug, and an elevated 5-year risk for cardiovascular disease. The prevalence of undiagnosed pre-diabetes/diabetes was highest in those aged 25-34 years at 34.2%. CONCLUSIONS: Clinical detection of pre-diabetes or diabetes in people with psychosis was strongly dependent on established risk factors for type 2 diabetes in the population but not on current antipsychotic drug treatment or psychiatric case management which should ensure regular screening. Screening must become a clinical priority and should not wait until age 40.
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