Cited by 119Diabetes, Cardiovascular Risks, and LipoproteinsSchizophrenia research and treatmentMental Health Treatment and Access

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Prevalence of type 2 diabetes in psychiatric disorders: an umbrella review with meta-analysis of 245 observational studies from 32 systematic reviews

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Lindekilde, Nanna, Scheuer, Stine H., Rutters, Femke, Knudsen, Lenette, Lasgaard, Mathias, Rubin, Katrine H., Henriksen, Jan Erik, Kivimäki, Mika, Andersen, Gregers S., Pouwer, Frans·2022·Diabetologia

DOI 10.1007/s00125-021-05609-x

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Abstract

Aims/hypothesis Estimates of the global prevalence of type 2 diabetes vary between 6% and 9%. The prevalence of type 2 diabetes has been investigated in psychiatric populations but a critical appraisal of the existing evidence is lacking, and an overview is needed. This umbrella review summarises existing systematic reviews of observational studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder.Methods We searched PubMed, EMBASE, PsycINFO and the Cochrane Database of Systematic Reviews from inception to 17 January 2021 and screened reference lists of included systematic reviews. On the basis of prespecified criteria, we included systematic reviews investigating the prevalence of type 2 diabetes in adults (aged ≥18 years) with a psychiatric disorder. Titles and abstracts of 5155 identified records and full texts of 431 selected studies were screened by two independent reviewers, based on predefined eligibility criteria and an a priori developed extraction form, following the PRISMA and MOOSE guidelines. Risk of bias was assessed with the ROBIS instrument. Data extracted from primary studies were synthesised using random-effects meta-analyses.Results A total of 32 systematic reviews with 245 unique primary studies were identified and met inclusion criteria. Twelve had low risk of bias. They reported type 2 diabetes prevalence estimates ranging from 5% to 22% depending on the specific psychiatric disorder. We meta-analysed data for ten categories of psychiatric disorders and found the following prevalence estimates of type 2 diabetes: in people with a sleep disorder: 40%; binge eating disorder: 21%; substance use disorder: 16%; anxiety disorder: 14%; bipolar disorder: 11%; psychosis: 11%; schizophrenia: 10%; a mixed group of psychiatric disorders: 10%; depression: 9%; and in people with an intellectual disability 8%. All meta-analyses revealed high levels of heterogeneity.Conclusions/interpretation Type 2 diabetes is a common comorbidity in people with a psychiatric disorder. Future research should investigate whether routine screening for type 2 diabetes and subsequent prevention initiatives for these people are warranted. PROSPERO registration no. CRD42020159870.

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Systemic inflammation, oxidative damage and neurocognition predict telomere length in a transdiagnostic sample stratified by global DNA methylation levels
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“SZ, BD, and MDD were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition [DSM-5] 22 .”
Method
Identifying depression, diabetes distress, and suicidality among adolescents with diabetes
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“Research has suggested that the metabolic impact that diabetes may have on nerve endings and blood vessels may inhibit brain functioning and potentially increase depression (Lindekilde et al., 2022; Northam, 2004).”
Protocol for the diabetes, distress and disparities (3D) study: an explanatory sequential mixed-methods design
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Is There a Link Between Type 2 Diabetes Mellitus and Negative Symptoms in Schizophrenia? A Scoping Review
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“The comorbidity of schizophrenia and T2DM is well documented in the literature [10–12].”
The psychosocial problem areas, needs and resources in people with coexisting schizophrenia and type 2 diabetes. Design and results of a survey study
Rønne, S. T., Rothmann, M. J., Jørgensen, R., Joensen, L. E., Cleal, B. R., Gæde, P., Holt, R. I. G., & Arnfred, S. (2025) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2025.2524371 · Cited by 2
“People with severe mental illness, including schizophrenia, are at higher risk of developing type 2 diabetes compared to people without severe mental illness [1,2].”
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The Diabetes Attitudes Wishes and Needs ( DAWN )‐ SMI study: A cross sectional comparison of the psychosocial impact of diabetes in adults with and without severe mental illness
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Antidepressants and Risk of Mortality in People with Depressive Disorder and Co-Occurring Type 2 Diabetes Mellitus: A 20-Year Population-Based Cohort Study
Ho, M. T. H., Chan, J. K. N., Lo, H. K. Y., Fang, C. Z., Wong, C. S. M., Lee, K. C. K., Lai, F. T. T., Ng, A. P. P., Wong, W. C. W., & Chang, W. C. (2026) · Psychotherapy and Psychosomatics · doi:10.1159/000550667 · Cited by 2
The Role of the Ketogenic Diet in Modulating Biochemical Pathophysiology in Psychiatric and Neurodegenerative Disorders
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Exposure of Pregnancy to Pregestational Diabetes, Gestational Diabetes, and Antidiabetic Medications With Especial Focus on Major Congenital and Cardiac Malformations in Offspring
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Longitudinal assessment of the impact of prevalent diabetes on hospital admissions and mortality in the general population: a prospective population-based study with 19 years of follow-up
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“Previous studies have demonstrated that psychiatric disease may increase the risk of new-onset diabetes [30, 31] and associates with prevalent diabetes [32].”
Background
The Overlooked Risk of Venous Thromboembolism in Psychiatric Patients: Epidemiology, Pathophysiology, and Implications for Clinical Care
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“45 These ﬁ ndings emphasize the critical need for regular metabolic monitoring and proactive management of diabetes risk in psychiatric patients, especially those undergoing antipsychotic treatment.”
Recruiting underrepresented populations for surveys: the case of people with schizophrenia and coexisting diabetes
Rønne, S. T., Arnfred, S., Gæde, P., Cleal, B. R., & Jørgensen, R. (2025) · Nordic Journal of Psychiatry · doi:10.1080/08039488.2025.2502932 · Cited by 2
“…with prescribed anti-diabetes medication increased the number of eligible patients, but it still represents a low proportion of the total in Region Zealand, where approximately 4,400 people have schizophrenia [29], and according to an umbrella review, about 10% have type 2 diabetes diagnoses [30].”
Unravelling the joint genetic architecture between psychiatic and insulin-related traits in the general populationPreprint
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Great Expectations: Semaglutide as Antidiabetic Weight Management in a Psychiatric Hospital
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Prevalence and Risk Factors of Type 2 Diabetes Mellitus among Depression Inpatients from 2005 to 2018 in Beijing, China
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“In English publications, the recent umbrella review (published in 2021) summarized 3 systematic reviews to pool the prevalence of T2DM in patients with depression [ 15 ].”
Polygenic risk score of glycemic homeostasis, Type 2 Diabetes Mellitus and glycemic components in first episode psychosis
Segura, À. G., Verdolini, N., Valli, I., García‐Rizo, C., Díaz‐Caneja, C. M., Vieta, E., Mezquida, G., Lobo, A., González-Pinto, A. M., Andreu-Bernabeu, Á., et al. (2025) · Schizophrenia Research · doi:10.1016/j.schres.2025.09.019 · Cited by 1
Prevalence, correlates, and the association of psychotic-like experience with impaired quality of life among Chinese patients with diabetes mellitus: a large-scale cross-sectional study
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Interaction of self-efficacy and sense of personal control on diabetes distress in older adults with type 2 diabetes: a cross-sectional study
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“This fosters self-management behaviors, enhancing confidence and capability to execute health actions such as personalized consultations, dietary modifications, structured physical exercise, and stress management techniques (33).”
Clinical Intervention Following Detection of Incident Diabetes Within a Large Psychiatric Service System: A Chart Review Study
Kølbæk, P., Rohde, C., Speed, M. S., Thomsen, H. H., & Østergaard, S. D. (2026) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.70114 · Cited by 1
“Previous studies have primarily examined screening practices and T2D prevalence rates [4], while there has been less emphasis on the extent of clinical intervention following detection of incident T2D in psychiatric services.”
Antidiabetes agents and risk of incident depression in 686,522 people with type 2 diabetes mellitus: A 20-year population-based cohort study
Ho, M. T. H., Chan, J. K. N., Lo, H. P., Fang, C. Z., Wong, C. S. M., Lee, K. C. K., Lai, F. T. T., Ng, A. P. P., Wong, W. C. W., & Chang, W. C. (2026) · Psychological Medicine · doi:10.1017/s0033291726104759 · Cited by 1
Weight loss and gut microbial changes associated with semaglutide among people living with schizophrenia receiving clozapine or olanzapine: An open-label 24-week semaglutide intervention and 76-week trial
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Antipsychotic Exposure and Pharmacologically Treated Type 2 Diabetes in Dutch Youths
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The effectiveness of diabetes training of psychiatric health professionals on individuals with diabetes and psychiatric disorders – a pragmatic controlled trial in Denmark
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“Diabetes is two to three times more common among individuals with psychiatric disorders than in the general population [4], due in part to weight gain arising from the use of psychotropic drugs and unhealthy life-style behaviors and inadequate diabetes management [5].”
Self-citation
High Rates of Abnormal Glucose Metabolism Detected by 75 g Oral Glucose Tolerance Test in Major Psychiatric Patients with Normal HbA1c and Fasting Glucose Levels
Yoshida, S., Aizawa, E., Ishihara, N., Hattori, K., Segawa, K., & Kunugi, H. (2025) · Nutrients · doi:10.3390/nu17040613 · Cited by 1
“[14].”
Diabetes und Psyche
de Zwaan, M. (2022) · Die Diabetologie · doi:10.1007/s11428-022-00923-3
Prevalence of Psychopathology in Bariatric Surgical Candidates with Type 2 Diabetes Mellitus: Systematic Review
Pekin, C., McHale, M., & Byrne, G. J. (2022) · Global Journal of Obesity Diabetes and Metabolic Syndrome · doi:10.17352/2455-8583.000058
Prise en charge des maladies métaboliques chez les personnes atteintes de troubles psychiatriques. Presque tout reste à faire !
Halimi, S. (2022) · Médecine des Maladies Métaboliques · doi:10.1016/j.mmm.2022.09.011
Diabetes und Psyche - ein Update
de Zwaan, M. (2023) · Info Diabetologie · doi:10.1007/s15034-023-4505-6
Delirio y Diabetes tipo 2: Revisión actualizada de su asociación fisiopatológica en la persona mayor
Moreira, H. R. R., Mejía, M. F. M., & Alencastro, J. A. P. (2023) · LATAM Revista Latinoamericana de Ciencias Sociales y Humanidades · doi:10.56712/latam.v4i3.1110
Commonalities in systemic inflammation, oxidative damage and neurocognition predict telomere length in type 2 diabetes mellitus and severe mental disordersPreprint
Tabarés‐Seisdedos, R., Sánchez‐Ortí, J. V., Correa‐Ghisays, P., Balanzá‐Martínez, V., Saint-Gerons, D. M., Berenguer-Pascual, E., Mateo, C. R., Víctor, V., Forés-Martos, J., Valenzuela, C. S. M., et al. (2023) · Research Square · doi:10.21203/rs.3.rs-3710093/v1
Review: de rol van psychische stoornissen bij precisiegeneeskunde voor diabetes
Kremers, S. H. M., Elders, P. J. M., Doedes, E., de Wit, M., Pouwer, F., Beulens, J. W. J., & Rutters, F. (2024) · Nederlands Tijdschrift voor Diabetologie · doi:10.1007/s12467-024-1554-y
Self-citation
TREATMENT OF REFRACTORY DIABETIC FOOT ULCER USING MAGGOT THERAPY AND SURGICAL DEBRIDEMENT: A CASE REPORT
Parizad, N., Talebiazar, N., & Anzali, B. C. (2023) · Nursing and Midwifery Journal · doi:10.61186/unmf.21.9.679
Wesentliche somatische Komorbiditäten psychischer Erkrankungen
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Kartleggingsoversikt over sammenhengen mellom diabetes type 1 og 2 og psykiske lidelser
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Authors: Lindekilde, N., Scheuer, S. H., Rutters, F., Knudsen, L., Lasgaard, M., Rubin, K. H., Henriksen, J. E., Kivimäki, M., Andersen, G. S., & Pouwer, F.
Affiliations: University of Southern Denmark (DK)
Steno Diabetes Center Copenhagen (DK)
Amsterdam Public Health (NL)
Central Denmark Region (DK)
Odense University Hospital (DK)
Deakin University (AU)
Corresponding author: Lindekilde, Nanna
ORCID: Lindekilde, Nanna
Scheuer, Stine H.
Rutters, Femke
Knudsen, Lenette
Lasgaard, Mathias
Rubin, Katrine H.
Henriksen, Jan Erik
Kivimäki, Mika
Andersen, Gregers S.
Pouwer, Frans
Venue: Diabetologia
Publisher: Springer Science and Business Media LLC
Published: 2021-11-29
Volume: 65
Issue: 3
Pages: 440-456
ISSN: 0012-186X (ISSN-L)
1432-0428
DOI: 10.1007/s00125-021-05609-x
OpenAlex: W3216957364
Cited by: 119
References: 80
Citations by year: 2026: 27 · 2025: 31 · 2024: 28 · 2023: 19 · 2022: 14
FWCI: 2.34
Type: journal article
Language: en
Open access: green
pure.amsterdamumc.nl
Licence: other-oa
www.springer.com/tdm (tdm)
www.springer.com/tdm (vor)
Locations: Diabetologia (publishedVersion)
PubMed (publishedVersion)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
Pure Amsterdam UMC (acceptedVersion, other-oa)
University of Southern Denmark Research Portal (University of Southern Denmark) (acceptedVersion, other-oa)
UCL Discovery (University College London) (submittedVersion)
Figshare (submittedVersion, cc-by)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: NordForsk
Department of Psychology, Faculty of Health Sciences, University of Southern Denmark
The National Institute on Aging (R01AG062553)
The Academy of Finland (329202)
The UK Medical Research Council (R024227)
Helsinki Institute of Life Science
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Keywords: type 2 diabetes, mental illness, diabetes prevalence, comorbidities, sleep disorders, binge eating disorder, substance use disorders, anxiety disorders, bipolar disorder, psychosis, schizophrenia, depression, intellectual disability, diabetes screening
MeSH terms: Systematic Reviews as Topic, Adolescent, Adult, Anxiety Disorders, Mental Disorders, Diabetes Mellitus, Type 2, Humans, Comorbidity, Prevalence, Observational Studies as Topic

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Prevalence of type 2 diabetes in psychiatric disorders: an umbrella review with meta-analysis of 245 observational studies from 32 systematic reviews

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