The psychosis and type 2 diabetes service model (PODS) population profile study.

Abstract

Objective: To describe diabetes care received and views of people with severe mental illness (SMI) and type 2 diabetes (T2D) in an inner-city primary care setting.

Design: A cross-sectional study of adults with SMI and T2D from two primary care localities in south London.

Methods: Medical record data was extracted on annual diabetes review and participants invited for telephone interview.

Results: 125 adults participated, 37 completed interviews. 43 % were female, 48 %, 35 % and 16 % were: Black African/Caribbean, White, Asian/other ethnicity. Mean age= 59.47 years (SD:12.68), diabetes duration= 8.62 years (SD:6.10), systolic blood pressure (BP)= 133.42 mmHg (SD:17.28), diastolic BP= 81.42 mmHg (SD:8.93), BMI= 33.17 m/kg² (SD:7.22), HbA1c= 61.64 mmol/mol (SD:25.18). Older age (OR:1.06, 95 % C.I.:1.0, 1.10), shorter diabetes duration (OR:0.90, 95 % C.I.:0.84, 0.97) were associated with target HbA1c< /= 58 mM. Younger age and Black ethnicity were associated with BP> 140 mmHg (OR:0.94, 95 % C.I.:0.90, 0.98; OR:0.08 (95 % C.I.:0.01, 0.56). Being older was associated with cholesterol, < 5.0 mmol/mol (OR:1.06, 95 % C.I.:1.01, 1.11). Questionnaires demonstrated low physical activity, alcohol/drug use, diabetes distress, psychiatric symptoms. Interviews indicated that > 50 % wanted more support with SMI and T2D.

Conclusions: Younger, black people with SMI and T2D are potentially at greater cardiometabolic risk. Interviews suggest people with T2D and SMI group require more mental health and diabetes support.