Disparities in Diabetes Care

Frayne, Susan M.; Halanych, Jewell H.; Miller, Donald R.; Wang, Fei; Lin, Hai; Pogach, Leonard; Sharkansky, Erica J.; Keane, Terence M.; Skinner, Katherine M.; Rosen, Craig S.; Berlowitz, Dan R.

doi:10.1001/archinte.165.22.2631

Cited by 295 publications

(73 citation statements)

References 63 publications

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“…Furthermore, the risk of metabolic syndrome is estimated to be twofold higher, and the prevalence of DM2 three-to fivefold higher than the general population , De Hert et al 2006. Despite these implications, those with serious mental illness and DM2 are insufficiently monitored and undertreated (Frayne et al 2005, Kreyenbuhl et al 2006, Goldberg et al 2007. Moreover, mortality among those with serious mental illness and DM2 is higher than in those diagnosed with DM2 or serious mental illness alone (Jackson et al 2007, Vinogradova et al 2010.…”

Section: Introductionmentioning

confidence: 99%

Metformin attenuates olanzapine-induced hepatic, but not peripheral insulin resistance

Remington

Teo

Wilson

et al. 2015

Journal of Endocrinology

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Antipsychotics (APs) are linked to diabetes, even without weight gain. Whether anti-diabetic drugs are efficacious in reversing the direct effects of APs on glucose pathways is largely undetermined. We tested two metformin (Met) doses to prevent impairments seen following a dose of olanzapine (Ola) (3 mg/kg); glucokinetics were measured using the hyperinsulinemic-euglycemic clamp (HIEC). Met (150 mg/kg; nZ13, or 400 mg/kg; nZ11) or vehicle (Veh) (nZ11) was administered through gavage preceding an overnight fast, followed by a second dose prior to the HIEC. Eleven additional animals were gavaged with Veh and received a Veh injection during the HIEC (Veh/Veh); all others received Ola. Basal glucose was similar across treatment groups. The Met 400 group had significantly greater glucose appearance (R a ) in the basal period (i.e., before Ola, or hyperinsulinemia) vs other groups. During hyperinsulinemia, glucose infusion rate (GINF) to maintain euglycemia (reflective of whole-body insulin sensitivity) was higher in Veh/Veh vs other groups. Met 150/Ola animals demonstrated increased GINF relative to Veh/Ola during early time points of the HIEC. Glucose utilization during hyperinsulinemia, relative to basal conditions, was significantly higher in Veh/Veh vs other groups. The change in hepatic glucose production (HGP) from basal to hyperinsulinemia demonstrated significantly greater decreases in Veh/Veh and Met 150/Ola groups vs Veh/Ola. Given the increase in basal R a with Met 400, we measured serum lactate (substrate for HGP), finding increased levels in Met 400 vs Veh and Met 150. In conclusion, Met attenuates hepatic insulin resistance observed with acute Ola administration, but fails to improve peripheral insulin resistance. Use of supra-therapeutic doses of Met may mask metabolic benefits by increasing lactate.

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Section: Introductionmentioning

confidence: 99%

Metformin attenuates olanzapine-induced hepatic, but not peripheral insulin resistance

Remington

Teo

Wilson

et al. 2015

Journal of Endocrinology

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“…However, a recent systematic review on the quality of health care of physical illnesses in mentally ill patients, compared to those without mental illness, showed that most of the studies found inequity. 1 These studies emanated predominantly from the US, as well from the UK, Finland, and the Netherlands [2][3][4][5][6][7][8][9] and, for the most part, they were secondary evaluations of routine data. There is also a scarcity of studies surrounding other socially stigmatising diseases such as schizophrenia or depression.…”

Section: Introductionmentioning

confidence: 99%

Are patients with dementia treated as well as patients without dementia for hypertension, diabetes, and hyperlipidaemia?

Müther

Abholz²,

Wiese³

et al. 2010

Br J Gen Pract

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BackgroundPatients suffering from dementia are at risk of being treated differently by GPs from patients without it. Explanations for this could be stigmatisation, treatment with a palliative approach, and the result of the disease process. AimTo ascertain whether patients with dementia are treated differently, the index diseases of hypertension, diabetes, and hyperlipidaemia were used to measure care. Design of studyRetrospective matched control study. SettingGerman general practice. MethodSixteen GP practices recruited all their patients with dementia and at least one of the index diseases. Patients without dementia but only the index diseases were matched for age, sex, index disease, and practice, resulting in 216 pairs of patients with and without dementia. From the files, blood pressure, blood sugar/glycated haemoglobin, cholesterol, the dates of measurement, the number of doctor-patient contacts, and the prescribed medication to treat the three conditions under scrutiny were documented. For analysis, t-tests and χ²-tests were used.

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“…However, healthcare disparities exist even for adults with serious mental illnesses who receive medical care [9][10][11][12][13][14] and physicians may be reluctant to treat patients with mental illnesses, inclined to misattribute physical complaints to their psychiatric illnesses, and underestimate the presence of medical disorders in these patients [15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

et al. 2008

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To help inform the design of a self-management intervention for improving the physical health of adults with serious mental illnesses, we conducted focus groups about their perceived medical care and physical health needs. Adults with serious mental illnesses participated in four semi-structured focus groups conducted at a transitional living facility, a social club, and a Hispanic outpatient mental health clinic. Questions included their recent experiences of seeking medical care, the effect of having a mental illnesses diagnosis, strategies for active self-care, and perceived barriers to better physical health. In addition to various systemic barriers to better medical care, participants articulated limited knowledge and self-efficacy regarding active self-management of their physical health. Despite their interest in learning more about health promotion, most participants expressed a sense of personal futility and powerlessness in improving their health. These data suggest that any effort to improve the wellbeing of these adults will need to address self-efficacy in the hope of improving self-care for their physical health needs.

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Disparities in Diabetes Care

Abstract: Patients with mental illness merit special attention in national diabetes quality improvement efforts.

Cited by 295 publications

References 63 publications

Metformin attenuates olanzapine-induced hepatic, but not peripheral insulin resistance

Metformin attenuates olanzapine-induced hepatic, but not peripheral insulin resistance

Are patients with dementia treated as well as patients without dementia for hypertension, diabetes, and hyperlipidaemia?

Self-Efficacy and Self-Care: Missing Ingredients in Health and Healthcare among Adults with Serious Mental Illnesses

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