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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
Open accessAbstract
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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“Psychiatric disorders, including disordered eating behaviors, are common, often unrecognized, and contribute to poor outcomes in diabetes (32).”
From Management of Hyperglycemia in Type 2 Diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) (2022) · cites this paper as [32]
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Metadata
- 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
- Venue
- Diabetologia
- Published
- 2021-11-29
- Volume
- 65
- Issue
- 3
- Pages
- 440-456
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- 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
- 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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