ECE2016 Eposter Presentations Diabetes (to include epidemiology, pathophysiology) (83 abstracts)
High prevalence of diabetes and pre-diabetes in psychiatry inpatients
Pratyusha Naidu 1 , Leonid Churilov 3 , Alvin Kong 1 , Richard Kanaan 9 , Henry Wong 2 , Arielle Van Mourik 2 , Anthony Yao 2 , Elizabeth Cornish 1 , Graeme K Hart 4 , Elizabeth Owen-Jones 5 , Raymond Robbins 7 , Que Lam 6 , Katherine Samaras 10 , Jeffrey Zajac 1, & Elif I Ekinci 1,
1Department of Endocrinology, Austin Health, Melbourne, Victoria, Australia; 2Department of General Medicine, Austin Health, Melbourne, Victoria, Australia; 3The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia; 4Department of Intensive Care, Austin Health, Melbourne, Victoria, Australia; 5Austin Centre for Applied Clinical Informatics, Austin Health, Melbourne, Victoria, Australia; 6Department of Pathology, Austin Health, Melbourne, Victoria, Australia; 7Department of Administrative Informatics, Austin Health, Melbourne, Victoria, Australia; 8University of Melbourne, Melbourne, Victoria, Australia; 9Department of Psychiatry, Austin Health, Melbourne, Victoria, Australia; 10St Vincent’s Clinical School, Sydney, New South Wales, Australia.
Objective: To determine the prevalence and characteristics of psychiatry inpatients with type 2 diabetes and pre-diabetes, compared to psychiatry inpatients without diabetes.
Research design and methods: Inpatients aged >30 years at the Austin psychiatry unit (February 2014–April 2015) had HbA1c measurements as part of the Diabetes Discovery Initiative. Patients were divided into three groups – diabetes (HbA1c ≥6.5%, 48 mmol/mol), pre-diabetes (HbA1c 5.7–6.4%, 39 mmol/mol-46 mmol/mol) and no diabetes (HbA1c ≤ 5.6%, 38 mmol/mol). Data on baseline characteristics, co-morbidities, psychiatric illnesses and treatment were collected.
Results: Of 335 psychiatry inpatients (median age 41 years) 14% (n=46) had diabetes and 19% (n=63) had pre-diabetes, more than threefold higher than the aged matched general population. The most prevalent diagnoses were schizophrenia, depression and substance abuse. Approximately 50% of inpatients were on atypical antipsychotics or anti-depressants. Compared to inpatients without diabetes, those with diabetes and pre-diabetes were older (median age 49 and 46 vs 40, P=<0.001). Patients with diabetes compared to those without diabetes were at least twice as likely to have hypertension, obesity and hyperlipidaemia (all P≤0.002). Multivariable analysis revealed the main significant variables associated with diabetes to be age (P=0.02), substance abuse (P=0.04), hyperlipidemia (P=0.03) and aripiprazole use (P=0.01).
Conclusions: Despite relative youth, one third of all psychiatric inpatients have diabetes or pre-diabetes. Presence of diabetes in psychiatric inpatients is associated with older age and substance abuse. The management of glycaemic status in psychiatric inpatients following discharge is difficult and hence routine HbA1c measurement as an inpatient presents an opportunity to address glycaemic management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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