Background
Patients with schizophrenia are at least twice as likely to develop diabetes mellitus compared to the general population. This is of significance in Qatar given the high prevalence of obesity and diabetes. Furthermore, the lifespan of people with schizophrenia and diabetes is shortened by approximately15 years due to long-term microvascular and macrovascular complications. High quality diabetes care can significantly reduce morbidity and mortality. We assessed the level of diabetes care delivered to patients with schizophrenia and diabetes compared to those with diabetes alone.
Methods
We performed a retrospective chart review of patients with diabetes mellitus with (n=73) and without (n=73) schizophrenia. Demographic information and electronic medical records were reviewed for 6-month and 1-year American Diabetic Association standards of diabetes care. Optimal diabetes care was defined as having completed glycated hemoglobin (HbA1c), lipid profile and retinal examination within 12 months.
Results
Optimal diabetes care was significantly lower in patients with schizophrenia and diabetes compared to diabetes alone [26.0% (n=19/73) vs 52.1% (n=38/73), p=0.002]. Patients with diabetes and schizophrenia were also significantly less likely to have had body mass index recorded within six months (p=0.008) and HbA1c (p=0.006), lipid profile (p=0.015), estimated glomerular filtration rate (eGFR) (p=0.001) and order for retinal screening (p=0.004) over 12 months. After adjusting for multiple comparisons, only assessment of eGFR (p=0.01) and order for retinal screening (p=0.04) remained significant.
Conclusion
Patients with schizophrenia and diabetes in Qatar receive sub-optimal diabetes care compared to those with diabetes alone.