Department of Medicine, Division of Endocrinology and Metabolism, University of Toronto, Toronto, Ontario, Canada.
Diabetes Care. 2011 Feb;34(2):398-402. doi: 10.2337/dc10-1139. Epub 2010 Oct 26.
Diabetes mellitus (DM) is a complex, chronic disease requiring active self-management and coordinated care. This study aimed to evaluate the relationship between schizophrenia and risk of preventable, acute DM complications.
With the use of administrative data, a retrospective study assessed acute DM complications (emergency department [ED] visits or hospitalization for hypo- or hyperglycemia and hospital admissions for infections) among Ontario residents ages 18-50 with schizophrenia and newly diagnosed DM between 1995 and 2005, comparing people with and without pre-existing schizophrenia. Primary outcome was ED visit or hospitalization for hypo- or hyperglycemia. Secondary outcome was the first of either the primary outcome or hospitalization for infection.
People with schizophrenia had a 74% greater risk of requiring a hospital visit for hypo- or hyperglycemia (hazard ratio [HR] = 1.74, 95% confidence interval 1.42-2.12) compared with those without schizophrenia. The risk was similar when the outcome included infection (HR = 1.62, 95% CI 1.39-1.89). Outcomes remained significant after adjustment for baseline characteristics.
People with schizophrenia are at greater risk for developing an acute complication of DM. Understanding this relationship will direct future studies assessing barriers to care and implementation of individualized approaches to care for this population.
糖尿病（DM）是一种复杂的慢性病，需要积极的自我管理和协调护理。本研究旨在评估精神分裂症与可预防的急性 DM 并发症风险之间的关系。
利用行政数据，一项回顾性研究评估了 1995 年至 2005 年间安大略省年龄在 18 至 50 岁之间患有精神分裂症和新诊断为 DM 的居民中急性 DM 并发症（低血糖或高血糖急诊就诊或住院、感染住院），比较了有和没有预先存在的精神分裂症的人群。主要结局是低血糖或高血糖的急诊就诊或住院。次要结局是首次出现主要结局或感染住院。
与无精神分裂症的患者相比，患有精神分裂症的患者低血糖或高血糖需要住院治疗的风险增加了 74%（风险比[HR] = 1.74，95%置信区间 1.42-2.12）。当结局包括感染时，风险相似（HR = 1.62，95%CI 1.39-1.89）。调整基线特征后，结果仍然显著。
患有精神分裂症的患者发生 DM 急性并发症的风险更高。了解这种关系将指导未来的研究评估护理障碍，并为这一人群实施个性化的护理方法。
