Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar.
Weill Cornell Medicine-Qatar, Ar-Rayyan, Qatar.
BMC Psychiatry. 2021 Mar 12;21(1):149. doi: 10.1186/s12888-021-03121-5.
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 is shortened by approximately 15 years, partly 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 in Qatar with schizophrenia and diabetes compared to those with diabetes alone.
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 to determine adherence to American Diabetes Association standards of diabetes care in the last 6 and 12 months. Optimal diabetes care was defined as having completed glycated hemoglobin (HbA1c), lipid profile and retinal examination within 12 months.
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 6 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 examination (p = 0.004) over 12 months. After adjusting for multiple comparisons, only assessment of eGFR (p = 0.01) and order for retinal examination (p = 0.04) remained significant.
Patients in Qatar with schizophrenia and diabetes, receive sub-optimal diabetes care compared to those with diabetes alone.
与普通人群相比，精神分裂症患者患糖尿病的可能性至少高出两倍。鉴于肥胖和糖尿病的高患病率，这在卡塔尔意义重大。此外，精神分裂症患者的预期寿命缩短了大约 15 年，部分原因是长期的微血管和大血管并发症。高质量的糖尿病护理可以显著降低发病率和死亡率。我们评估了与单独患有糖尿病的患者相比，在卡塔尔患有精神分裂症和糖尿病的患者接受的糖尿病护理水平。
我们对患有糖尿病的患者（n=73）和没有糖尿病的患者（n=73）进行了回顾性病历审查。审查了人口统计学信息和电子病历，以确定在过去 6 个月和 12 个月内是否符合美国糖尿病协会的糖尿病护理标准。最佳糖尿病护理定义为在 12 个月内完成糖化血红蛋白（HbA1c）、血脂谱和视网膜检查。
与单独患有糖尿病的患者相比，患有精神分裂症和糖尿病的患者接受最佳糖尿病护理的比例明显较低[26.0%（n=19/73）vs. 52.1%（n=38/73），p=0.002]。患有糖尿病和精神分裂症的患者在 6 个月内记录体重指数的可能性也明显较低（p=0.008），且 HbA1c（p=0.006）、血脂谱（p=0.015）、估算肾小球滤过率（eGFR）（p=0.001）和视网膜检查的医嘱（p=0.004）也明显较低。在调整了多次比较后，只有 eGFR 的评估（p=0.01）和视网膜检查的医嘱（p=0.04）仍然显著。
与单独患有糖尿病的患者相比，卡塔尔患有精神分裂症和糖尿病的患者接受的糖尿病护理不理想。
