Patient and Health Care Factors Associated With Long-term Diabetes Complications Among Adults With and Without Mental Health and Substance Use Disorders

Abstract

Key PointsQuestionAmong patients with newly diagnosed diabetes, are preexisting mental health (MH) or substance use (SU) disorders and primary care utilization before a new diabetes diagnosis associated with the long-term severity of diabetes complications?FindingsIn this cohort study of 122 992 patients in the US Department of Veterans Affairs health system, more than 90% of patients with MH or SU disorders had primary care visits before diabetes was newly diagnosed, compared with approximately 58% of patients without MH or SU disorders. Patients with MH or SU disorders experienced significantly lower severity of diabetes complications for 7 years thereafter, compared with patients without preexisting MH or SU disorders, even after controlling for sociodemographic characteristics and medical comorbidities.MeaningAmong patients with MH or SU disorders, receiving more medical and mental health care from an integrated health care system before the onset of diabetes is associated with modest, albeit impermanent, health benefits after the onset of diabetes.

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