This article is more than 5 years old. Information may no longer be current.

Majority of adults with severe mental illness not screened for diabetes

Despite an elevated risk for type 2 diabetes, adults with a severe mental illness who take antipsychotic medications are rarely screened for the disease, according to research published in JAMA Internal Medicine.

Christina Mangurian , MD, and colleagues found that 30.1% of adults with a severe mental illness who were taking antipsychotic medications received a diabetes-specific screening.

Mangurian, an associate professor of clinical psychiatry at the University of California, San Francisco School of Medicine, said in a press release regarding the study that the U.S. health care system is fragmented for patients dealing with mental illnesses.

"For example, the mental health electronic medical record is totally separate from their primary care electronic record, truly limiting the quality of care this vulnerable population can receive," she said in the release. "As a community psychiatrist, I see so many people who are untreated or undertreated for physical health problems because of this lack of integration.”

Mangurian and colleagues conducted a retrospective cohort study in which they analyzed data from the California Medicaid and Client and Service Information systems between January 2009 and December 2009, as well as October 2010 to September 2011. They defined diabetes-specific screenings as those that included a glycated hemoglobin test or glucose-specific fasting serum test.

Results demonstrated that, of the 50,915 participants, 15,315 (30.1%) received a diabetes-specific screening in a year-long period and 15,832 (31.1%) did not receive any type of glucose screening.

The researchers also reported that participants who visited a primary care provider at least once during the year-long period were more likely to receive a diabetes-specific screening (adjusted prevalence ratio = 1.8; 95% CI, 1.62-2; P < .001).

"Individuals with [severe mental illness] who had at least one primary care visit in addition to mental health services were more than twice as likely to be screened than those who did not," Mangurian and colleagues wrote. "This observation supports the value of burgeoning efforts to integrate behavioral health and primary care. Growing evidence supports the value of screening for diabetes mellitus in higher-risk populations, such as those receiving treatment with antipsychotic medications, including first-generation and second-generation agents that commonly result in co-occurring obesity." – by Chelsea Frajerman Pardes

Disclosures: One author reported serving on the data safety monitoring boards for Amgen, Bristol-Myers Squibb and Merck and reported receiving honoraria from American Physician Institute, American Psychiatric Association, American Society for Clinical Psychopharmacology, CMEology, CME Outfitters, Cleveland Clinic and VIVUS, all outside of the present work. Please see the full study for a list of all other authors' relevant financial disclosures.