Association of mental disorders and quality of diabetes care – A six-year follow-up study of type 2 diabetes patients in North Karelia, Finland

Abstract

To compare the quality of diabetes care among type 2 diabetes patients with and without mental disorders during six-year follow-up in North Karelia, Finland. Methods: All type 2 diabetes patients (n = 10190) were analysed using the electronic health records data from 2011-12 to 2015-16. The diabetes care was evaluated using the measurement activity and the achievement of the treatment targets for HbA1c and LDL. Results: Monitoring of HbA1c and LDL levels improved among all patient groups, except the dementia patients. The proportion of those achieving the HbA1c target declined and those achieving the LDL target improved in all patient groups. Differences in the changes of achievement of the target HbA1c level among patients with dementia and depression were observed when compared with those having only type 2 diabetes. Conclusions: This study highlights the challenge of glucose level management as the age and comorbidities of the patients related to the care and achievements of the treatment targets. Mental disorders that are likely to affect patients' adherence to medication and other treatments should be taken into account and more support for self-care should be provided to such patients.

The bidirectional longitudinal association between depressive symptoms and HbA1c: A systematic review and meta‐analysis

“…The results of these studies and reasons for exclusion are summarised in Table . Out of these thirteen studies, five reported that major depressive disorder/higher levels of depressive symptoms were longitudinally associated with higher levels of HbA 1c, 26,28–30,36 while eight did not find an association 22,25,27,32–35,47 . One study described their results without reporting an effect estimate 47 …”

“…The results of 11 studies could be subjected to meta‐analysis. Fifteen studies 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 had to be excluded from the meta‐analysis as the reported effect measures could not be pooled in a meta‐analysis. The exact reasons for exclusion can be found in Tables S5 and S6 .…”

“…Table S3 presents the characteristics of the 26 studies in the systematic review. Sixteen studies consisted of individuals with type 2 diabetes, 24 , 25 , 26 , 29 , 30 , 31 , 32 , 33 , 37 , 38 , 39 , 40 , 43 , 44 , 45 , 46 six with type 1 diabetes, 22 , 28 , 34 , 35 , 36 , 41 two included a mixed population 27 , 47 and two did not specify the type of diabetes. 23 , 42 The mean age of participants ranged from 22.6 to 67.9 years.…”

“…Study duration varied from 6 months up to twelve years with two to six follow‐up time points. Three studies used a retrospective study design 30 , 32 , 46 ; nonetheless, we decided to include them as neither depression nor HbA 1c were relevant for the selection of the exposed and non‐exposed study participants. Six studies did not report adjusted outcome measures, and 13 studies did not report 95% CI.…”

Effectiveness of Smartphone-Based Lifestyle Interventions on Women with Gestational Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…57 Moreover, the psychological status of pregnant women also has a certain impact on maternal and offspring outcomes. 55,58,59 Evidence suggests that strategies to tailor psychological interventions modules based on smartphone help adults with diabetes cope positively and achieve diabetes treatment goals. 60 Therefore, psychological intervention elements must be integrated into smartphone-based lifestyle interventions to investigate the effects on psychological status among women with GDM in future studies.…”