Endocrine Abstracts

Introduction: A mental disorder is characterized by a significant clinical impairment in an individual’s cognitive state, emotional regulation, or behavior. It typically accompanies a sense of distress or functional impairments in crucial areas of life. The coexistence of diabetes and mental illness is not uncommon. However, due to the necessity of a collaborative approach between healthcare providers and patients to optimize treatment and considering the chronic nature of both conditions, it is essential to explore specific aspects.

Objective: Our study aims to assess factors influencing the management of diabetic patients with psychiatric disorders to enhance their adherence to treatment and follow-up.

Materials and Methods: This is a retrospective descriptive study conducted at the Endocrinology and Diabetology Department of CHU IBN ROCHD in Casablanca. It focuses on diabetic patients with psychiatric disorders requiring specialized hospital care in either the psychiatry or endocrinology department from January 2021 to December 2023; data were collected using Excel.

Results: In our study, 112 patients were included, comprising 68 men and 44 women. The overall average age of diabetic patients with psychiatric disorders was 40 years (ranging from 15 to 61 years). Two distinct peaks were observed: one during adolescence, where depression predominated, and another around 54 years, with a clear prevalence of psychoses. The prevalence of type 1 diabetes was higher in adolescence, with the basal-bolus regimen being essential, necessitating educational, medicinal, and psychotherapeutic support to prevent multiple hospitalizations due to complications such as ketoacidosis or hypoglycemia. Underlying depressions were often identified during stays in the endocrinology department in 22% of cases. For patients with type 2 diabetes or those with a debated diabetes type, representing 50% and 28% of the sample, respectively, and facing challenges in the applicability of educational strategies during psychoses or situations of hetero-aggression, oral antidiabetics were preferred if HbA1c values and diabetes duration allowed. Otherwise, premixed or basal-plus regimens were considered.

Conclusion: Managing diabetic patients with mental disorders remains a challenge for both healthcare professionals and caregivers. Thus, collaboration between endocrinologists, psychiatrists, and psychotherapists is crucial to mitigate the complications associated with these conditions.