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Cardiovascular disease is the leading cause of death in Type 2 diabetes, which commonly occurs in patients with serious mental illnesses (SMIs). We determined the extent to which patients with diabetes and SMI, relative to diabetes patients without SMI, met American Diabetes Association goals for cholesterol and blood pressure, met criteria for the metabolic syndrome, and were prescribed medications known to reduce cardiovascular events. We found that less than half of diabetes patients, both with and without SMI, met recommended goals for cholesterol levels; even fewer had adequate blood pressure control. In addition, a substantial proportion of all diabetes patients met metabolic syndrome criteria. However, diabetes patients with SMI were less likely to be prescribed cholesterol-lowering statin medications, angiotensin-converting enzyme inhibitors, and angiotensin receptor blocking agents than diabetes patients without SMI. Patients with both diabetes and SMI are treated less aggressively for high cardiovascular risk than diabetes patients without mental disorders. KeywordsType 2 diabetes; serious mental illness; cardiovascular risk; metabolic syndrome In 2002, Type 2 diabetes affected approximately 6.3% of the US population at an estimated cost of $132 billion (American Diabetes Association, 2003;Engelgau et al., 2004). Type 2 diabetes is associated with a twofold to fourfold increased risk for major cardiovascular events and is considered a coronary heart disease risk equivalent that confers a level of risk equal to that in patients with pre-existing cardiovascular disease (CVD; Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults, 2001). Cardiovascular and cerebrovascular complications of Type 2 diabetes account for 60% to 75% of deaths from this disease (Stamler et al., 1993). Metabolic abnormalities characteristic of Type 2 diabetes including insulin resistance and dyslipidemias contribute in part to the increased CVD risk, with emerging evidence suggesting that persistent hyperglycemia may also play a role (Nathan et al., 2003;Selvin et al., 2004 NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript frequent co-occurrence of hypertension, overweight and obesity, smoking, and reduced physical activity in patients with diabetes confers an additive CVD risk that exceeds the sum of their risks individually (Wilson et al., 1998). There is also mounting evidence that the cluster of risk factors that comprise the metabolic syndrome increases the risk for cardiovascular mortality , and by definition, would be expected to occur disproportionately in people with Type 2 diabetes.Persons with serious mental illnesses such as schizophrenia have an increased risk for Type 2 diabetes (Dixon et al., 2000) and other co-occurring medical conditions. Life expectancy in people with schizophrenia is 20% shorter than that of the general population (Newman and Bland, 1991), with the excess mortality largely attributed to higher rates of CVD (Brown et al., 2000;Os...

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Background and Objectives Opioid dependent patients are hospitalized frequently. We aimed to determine if initiation of buprenorphine treatment during hospitalization facilitates entry into treatment following discharge. Methods Retrospective case series (n = 47). Results Twenty‐two (46.8%) patients successfully initiated buprenorphine treatment within 2 months of discharge. Those patients obtaining a referral to a specific program were more successful in continuing treatment, but this difference did not reach statistical significance (59.1% vs 39.1%, p = 0.18). Discussion and Conclusions Hospitalization may be an important opportunity to engage opioid dependent patients to initiate buprenorphine treatment. Scientific Significance This study provides provisional support for utilizing buprenorphine for hospitalized patients. (Am J Addict 2015;24:10–14)