Al Alshaikh Lina, Doherty Anne M
Royal College of Surgeons, Dublin, Ireland.
Department of Psychiatry, University College Dublin, 63 Eccles Street, Dublin 7, Ireland.
J Clin Transl Endocrinol. 2023 Sep 29;34:100325. doi: 10.1016/j.jcte.2023.100325. eCollection 2023 Dec.
It has been suggested that there may be an association between type 1 diabetes (T1DM) and suicide, with one study reporting a rate 11 times that of the general population The aim of this paper was to investigate the association between Diabetic ketoacidosis (DKA: a life-threatening acute complication of T1DM) and suicidal behaviours in people with T1DM.
We performed a search of the following databases: PubMed, PsychInfo, and Embase for papers which explored the association between suicidal behaviours and self-harm with DKA in T1DM. We excluded case reports and review papers.
Only three papers explored the relationship between DKA and self-harm. One study found an association between DKA and self-harm in a national cohort of people with type 1 diabetes and schizophrenia. The second found a significant increase in psychiatric admissions for self-harm following an episode of DKA. The third study reported that patients with diabetes and a history of self-harm were at elevated risk of a range of diabetes complications including DKA. These findings indicate an association between DKA and self-harm and support the guidelines in recommending a psychosocial assessment where DKA cannot be explained.
This review suggests that DKA is associated with suicidal or self-injurious behaviours. The small number of studies and the seriousness of this issue highlight the importance of further research on this topic, to improve the evidence base for the identification and treatment of risk of suicidal behaviours in people with T1DM.
有研究表明1型糖尿病（T1DM）与自杀之间可能存在关联，一项研究报告称其发生率是普通人群的11倍。本文旨在调查糖尿病酮症酸中毒（DKA：T1DM的一种危及生命的急性并发症）与T1DM患者自杀行为之间的关联。
我们检索了以下数据库：PubMed、PsychInfo和Embase，以查找探讨T1DM患者自杀行为和自我伤害与DKA之间关联的论文。我们排除了病例报告和综述论文。
仅有三篇论文探讨了DKA与自我伤害之间的关系。一项研究在一个全国性的1型糖尿病和精神分裂症患者队列中发现了DKA与自我伤害之间的关联。第二项研究发现，DKA发作后因自我伤害而入院接受精神科治疗的人数显著增加。第三项研究报告称，有自我伤害史的糖尿病患者发生包括DKA在内的一系列糖尿病并发症的风险升高。这些发现表明DKA与自我伤害之间存在关联，并支持在无法解释DKA时进行社会心理评估的指南。
本综述表明DKA与自杀或自我伤害行为有关。研究数量较少以及该问题的严重性凸显了对这一主题进行进一步研究的重要性，以改善识别和治疗T1DM患者自杀行为风险的证据基础。
