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Published Online: 17 April 2017

Diabetes Prevalence Among Racial-Ethnic Minority Group Members With Severe Mental Illness Taking Antipsychotics: Double Jeopardy?

Christina Mangurian, M.D., M.A.S. [email protected], Walker Keenan, B.S., John W. Newcomer, M.D., Eric Vittinghoff, Ph.D., Jennifer M. Creasman, M.S.P.H., and Dean Schillinger, M.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 68, Number 8
https://doi.org/10.1176/appi.ps.201600356
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Abstract

Objective:

This study assessed differences in diabetes prevalence based on race-ethnicity among people with severe mental illnesses.

Methods:

This retrospective cohort study examined diabetes prevalence in 2009 among California Medicaid enrollees with severe mental illness who were screened for diabetes (N=19,364). Poisson regression assessed differences in diabetes prevalence by race-ethnicity. The sample was standardized to the U.S. population.

Results:

The overall prevalence of diabetes was 32.0%. The adjusted prevalence for all minority groups with severe mental illness, except for Asians, was significantly higher than for whites (1.21–1.28 adjusted prevalence ratios). With inverse probability weighting to reduce selection bias captured by measured factors, estimated prevalence of diabetes among screened participants was 27.3%.

Conclusions:

The prevalence of diabetes in minority groups with severe mental illness was significantly higher than among whites with severe mental illness. Mental health administrators should implement universal diabetes screening with specific outreach efforts targeting minority populations with severe mental illness.

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Information & Authors

Information

Published In

Go to Psychiatric Services
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Cover: Michigan Summer, by Ivan Albright, no date. Watercolor and gouache on paper. Mary and Earle Ludgin Collection, 1981.1164. © The Art Institute of Chicago.

Psychiatric Services
Volume 68 • Number 8 • August 01, 2017
Pages: 843 - 846
PubMed: 28412889

History

Received: 29 July 2016
Revision received: 29 November 2016
Accepted: 5 January 2017
Published online: 17 April 2017
Published in print: August 01, 2017

Keywords

  1. Antipsychotics, Drug effects/cardiovascular, Ethnic groups, Research/service delivery, Diabetes
  2. schizophrenia

Authors

Details

Christina Mangurian, M.D., M.A.S. [email protected]
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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Walker Keenan, B.S.
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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John W. Newcomer, M.D.
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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Eric Vittinghoff, Ph.D.
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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Jennifer M. Creasman, M.S.P.H.
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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Dean Schillinger, M.D.
With the exception of Dr. Newcomer, the authors are with the School of Medicine, University of California, San Francisco (UCSF), where Dr. Mangurian is with the Department of Psychiatry and the Weill Institute for Neurosciences, Dr. Vittinghoff is with the Department of Epidemiology and Biostatistics, Ms. Creasman is with the Clinical and Translational Science Institute (CTSI), and Dr. Schillinger is with the Department of Medicine. Dr. Mangurian and Dr. Schillinger are also with Zuckerberg San Francisco General Hospital, San Francisco. Dr. Newcomer is with the Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton.
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Notes

Send correspondence to Dr. Mangurian (e-mail: [email protected]).

Funding Information

National Institute on Minority Health and Health Disparities10.13039/100006545: P60MD006902, R25MD006832
National Institute of Diabetes and Digestive and Kidney Diseases10.13039/100000062: P30DK092924
National Institute of Mental Health10.13039/100000025: K23MH093689
Clinical and Translational Science Institute, University of California, San Francisco10.13039/100010511: KL2RR024130
Dr. Mangurian was supported by grant K23MH093689 from the National Institute of Mental Health; by the UCSF Hellman Fellows Award for Early-Career Faculty; and by the National Center for Research Resources, the National Center for Advancing Translational Sciences, and the Office of the Director, National Institutes of Health (NIH) through UCSF-CTSI grant KL2 RR024130. Mr. Keenan was supported by R25MD006832 from the National Institute on Minority Health and Health Disparities (NIMHD). Dr. Schillinger was supported by NIH center grant P30DK092924 from the National Institute of Diabetes and Digestive and Kidney Diseases to the Health Delivery Systems Center for Diabetes Translational Research and by NIMHD grant P60MD006902 to the Comprehensive Center of Excellence for Health and Risk in Minority Youth and Young Adults.

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