The role of mental disorders in precision medicine for diabetes: a narrative review

Kremers, Sanne H. M.; Wild, Sarah; Elders, Petra; Beulens, Joline W.J.; Campbell, David J.T.; Pouwer, Frans; Lindekilde, Nanna; Lloyd, Cathy E.; Rutters, Femke

doi:10.1007/s00125-022-05738-x

Cited by 10 publications

(9 citation statements)

References 77 publications

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“…T2D is both a primary cause of death and disability and an underlying risk factor for cardiovascular disease and cancer. Furthermore, it is intertwined with depression, anxiety, and other mental health issues that influence these negative health outcomes (13,14). Diabetes and other CCDs are also rooted in social determinants of health: less wealth, lower educational status, insecure housing, dietrelated disparities, less exercise, and greater environmental risk exposure, among other health risks.…”

Section: Introductionmentioning

confidence: 99%

Our National Approach to Diabetes

Califf¹

2023

Diabetes Care

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Section: Introductionmentioning

confidence: 99%

Our National Approach to Diabetes

Califf¹

2023

Diabetes Care

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“…However, the importance of behavioural and contextual factors is recognised increasingly as crucial in shaping the future of diabetes care, especially for type 2 diabetes. (57) For example, Hermanns et al (2022)(58) argue that the integration of behavioural, psychological, and glycaemic data could be key in the drive towards precision medicine in diabetes care by supporting personalised and real-time treatment adjustments and changes to care. They suggest that this might also be true for people with bipolar disorder or depression whereby monitoring could predict relapses which could be avoided with early intervention, consequently leading to an avoidance of deteriorating glucose values.…”

Section: Discussionmentioning

confidence: 99%

“…The current state of the evidence supports the notion that targeted work in collaboration with people with SMI is very much needed. (57) In a commentary on Lee et al, Kahkoska and colleagues (2023)(62) propose four priorities to maximise the potential of technology-enhanced behaviour-change interventions that are applicable across the population of people with type 2 diabetes, including those who also have SMI. Kahkoska et al suggest that equity, personalisation, integration with health services, and rigorous evaluation will be crucial going forward.…”

Section: Discussionmentioning

confidence: 99%

Supporting continuous glucose monitoring for people with serious mental illness and type 2 diabetes: Protocol for a co-design study

Brown,

Ajjan,

Siddiqi

et al. 2024

Preprint

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Introduction Compared with the general population, people with serious mental illness (SMI) are 2-3 times more likely to develop type 2 diabetes, have poorer outcomes, and die 15 to 20 years younger, often as a result of long-term physical health conditions. Standard diabetes care does not meet the needs of people with SMI and they are frequently excluded from research, missing out on innovation. As diabetes care increasingly uses technology like continuous glucose monitoring (CGM) it is important to consider the views of people with SMI when new interventions are developed. This is a study protocol to identify candidate components of a structured CGM intervention for people with SMI, including the co-design of a logic model and programme theory. Methods Drawing on experience-based co-design (EBCD) methods, we propose to collaborate with service-users, carers, and healthcare professionals to undertake early-phase development work for a novel intervention that maximises the potential of CGM to facilitate behaviour change. Fifteen participants will be recruited through existing cohorts and networks in England. The co-design will be informed by existing evidence and based on links between mechanisms of action and behaviour change techniques. Through a series of events (discovery sessions, co-design workshop, celebration event), we will identify candidate components for a prototype intervention ready for further development and testing. A logic model and programme theory will be developed and refined iteratively. Discussion The main output of this study will be a logic model and programme theory for a novel prototype intervention, ready for further testing following best practice intervention development, such as the Medical Research Council guidance for the development and evaluation of complex interventions. An intervention that makes CGM accessible for people with SMI has the potential to make a considerable contribution to reducing the profound health inequalities experienced by this population.

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“…Likewise, our findings were independent of depressive symptoms. Depression has in fact been the most studied mental health determinant of T2D 32 , alone or together with other mental health conditions. For example, symptoms of depression, anxiety, and insomnia, were found to increase the risk of pre-diabetes and T2D in Swedish middle-aged men but not women 33 .…”

Section: Hr [95% Ci] P-value Hr [95% Ci] P-valuementioning

confidence: 99%

Chronic insomnia, high trait anxiety and their comorbidity as risk factors for incident type 2 diabetes mellitus

Duquenne,

Samieri,

Chambaron

et al. 2024

Sci Rep

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The main objective of this study was to evaluate the association of the insomnia-anxiety comorbidity with incident type 2 diabetes (T2D) in a large prospective cohort. We selected adults without diabetes at baseline from the French NutriNet-Santé cohort who had completed the trait anxiety subscale of the Spielberger State-Trait Anxiety Inventory (STAI-T, 2013–2016) and a sleep questionnaire (2014); insomnia was defined according to established criteria. Using multivariable Cox models, we compared T2D risk across 4 groups: no insomnia or anxiety (reference), insomnia alone, anxiety alone (STAI-T ≥ 40), and comorbid anxiety and insomnia. Among 35,014 participants (mean baseline age: 52.4 ± 14.0 years; 76% women), 378 (1.1%) developed T2D over a mean follow-up of 5.9 ± 2.1 years. Overall, 28.5% of the sample had anxiety alone, 7.5%—insomnia alone, and 12.5%—both disorders. In the fully-adjusted model, a higher T2D risk was associated with anxiety-insomnia comorbidity (HR = 1.40; 95% CI 1.01, 1.94), but not with each disorder separately, compared to the group without insomnia or anxiety. The findings supported a positive association between anxiety-insomnia comorbidity and incident T2D among general-population adults. Future research using clinical diagnoses of mental disorders could confirm the findings and guide diabetes prevention programs.

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The role of mental disorders in precision medicine for diabetes: a narrative review

Cited by 10 publications

References 77 publications

Our National Approach to Diabetes

Our National Approach to Diabetes

Supporting continuous glucose monitoring for people with serious mental illness and type 2 diabetes: Protocol for a co-design study

Chronic insomnia, high trait anxiety and their comorbidity as risk factors for incident type 2 diabetes mellitus

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