Do people with mental health problems have an increased risk to develop diabetes mellitus?
Psychiatric disorders have in the last decades been documented as risk factors for later incidence of type 2 diabetes. However, which biological and behavioral factors mediate this association? The present project consist of an umbrella review and afterwards longitudinal cohort studies investigating this association and possible mediating mechanisms.
Diabetes mellitus is a common condition that affected an estimated number of 422 million people worldwide in 2014. Approximately 90 % of diabetic cases are individuals with type 2 diabetes and multiple risk factors have also shown to have an important role in the development of the disease. Increasing age, obesity, dietary factors and sedentary lifestyle are common known risk factors. Furthermore, mental health problems have been documented as risk factor for later incidence of type 2 diabetes. For example, multiple systematic reviews of longitudinal studies have concluded that depression is associated with an increased risk to develop type 2 diabetes. Likewise, systematic reviews and meta-analyses have investigated how respectively anxiety, bipolar disorder, PTSD and schizophrenia are associated with a higher risk to develop type 2 diabetes. The theoretical foundation of the present PhD-project is inspired by the biopsychosocial model. In line with previous research and theoretical understandings, an association between mental health problems and type 2 diabetes mellitus mediated by behavioral factors (e.g. unhealthy eating behaviors, physical inactivity, sleeping problems and smoking behavior), the use of psychotropic medication and biological factors is expected.
The aim of the present project is to test whether people with mental health problems are at increased risk to develop diabetes mellitus later in life. Furthermore, in case of significant associations, the project also aims to determinate potential mechanisms (e.g. behavioral or biological factors) linking mental health problems with the development of type 2 diabetes mellitus.
Description of the cohort
A national sample of adult Danish citizens with a psychiatric disorder and no prior diabetes diagnosis at baseline. Furthermore, a matched control group of adult Danish citizens without a psychiatric disorder and no prior diabetes diagnosis at baseline.
Data and biological material
The project is based on register data and data from a national health survey.
Collaborating researchers and departments
Department of Psychology, University of Southern Denmark
- Professor, Frans Pouwer, PhD (mainsupervisor)
STENO Diabetes Center, Odense University Hospital
- Director and Associate Professor, Jan Erik Henriksen, PhD (co-supervisor)
DEFACTUM, Central Denmark Region
- Associate professor, Mathias Lasgaard, PhD (co-supervisor)
OPEN, Odense Patient data Explorative Network, Odense University Hospital
- Associate professor, Katrine Hass Rubin, PhD (co-supervisor)
Publications associated with the project
Lindekilde N, Scheuer SH, Rutters F, Knudsen L, Lasgaard M, Rubin KH, Henriksen JE, Kivimäki M, Andersen GS, Pouwer F. Prevalence of type 2 diabetes in psychiatric disorders: an umbrella review with meta-analysis of 245 observational studies from 32 systematic reviews. Diabetologia. 2021 Nov 29. doi: 10.1007/s00125-021-05609-x. Epub ahead of print. PMID: 34841451.
Lindekilde N, Scheuer S, Rutters F, Henriksen JE, Rubin KH, Lasgaard M, Andersen GS, Pouwer F. The prevalence of type 2 diabetes in people with psychiatric disorders: an umbrella review protocol. Syst Rev. 2020 May 4;9(1):101. doi: 10.1186/s13643-020-01341-6. PMID: 32366297; PMCID: PMC7199336.
Lindekilde N, Rutters F, Erik Henriksen J, Lasgaard M, Schram MT, Rubin KH, Kivimäki M, Nefs G, Pouwer F. Psychiatric disorders as risk factors for type 2 diabetes: An umbrella review of systematic reviews with and without meta-analyses. Diabetes Res Clin Pract. 2021 Jun;176:108855. doi: 10.1016/j.diabres.2021.108855. Epub 2021 May 7. PMID: 33965448.