Endocrine Abstracts

People with diabetes mellitus experience increased rates of psychiatric disorders which may have a negative impact on glycaemic control¹. Psychological supports and interventions may ameliorate this. We aimed to examine the impact of psychiatric and psychological interventions on patient engagement and glycaemic metrics in adults attending a single tertiary level diabetes centre. People with diabetes who had been referred for psychiatric evaluation in our centre between 2015-2022 were included in this study. Clinical information, glycated haemoglobin (HbA1c), rate of inpatient admission and missed outpatient appointments were gathered retrospectively from medical records. Thirty-eight people were included, the median age was 32 (range = 19-60). The majority were female (52.6%), and had type 1 diabetes mellitus (86.1%). At baseline mean HBA1c was 86.5mmol/mol (± 23.5mmol/mol), mean missed outpatient appointments 3.8 appointments/year (±4.0) and mean hospitalisations from diabetes 0.6 admissions/year (±1.1). Following psychiatric and/or psychology intervention, HBa1c improved (86.5mmol/mol vs 79.4mmol/mol, decrease of 7.1mmol/mol, P < 0.002) and patients has less hospital admissions due to diabetes at one year (0.6 ±1.1 vs 0.2 ±0.5, P = 0.04). 46% of patients showed greater engagement in their care by having fewer unattended appointments. Our data highlights that adults with diabetes and comorbid psychiatric disorders have poor glycaemic control and service engagement at baseline. There was however, a statistically significant improvement in these parameters with psychiatric and psychological interventions stressing the importance of such services as part of the multidisciplinary management of people with diabetes mellitus.

Reference: 1. Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. Journal of affective disorders. 2012 Oct 1;142:S8-21.