Glucose, cholesterol and blood pressure in type II diabetes : a longitudinal observational study comparing patients with and without severe mental illness

INTRODUCTION: Patients with both severe mental illness (SMI) and type II diabetes (T2DM) have lower life expectancy than patients with T2DM alone, partly due to poor control of cardiovascular risk factors in comorbid patients. AIM: To compare levels of cholesterol, HbA1c and blood pressure in T2DM patients with and without SMI. METHOD: We analysed longitudinal clinical records of 30,353 people with T2DM (657 with SMI;29,696 controls without SMI) between 2001 and 2013 using the Clinical Practice Research Datalink (CPRD). We used mixed effects regression models to compare cardiovascular risk factors between SMI and controls. RESULTS: Patients with SMI had lower mean systolic blood pressure (SBP) (β -2.49; SE=0.45 P=<0.01) and were more likely to have extreme (high and low) values of HbA1c and SBP (OR 1.38, 95%CI: 1.16,1.64 and 1.76:1.40,2.21 respectively). DISCUSSION: People with T2DM and SMI have similar average values of cardiovascular risk factors to people with T2DM alone but are more likely to have values of HbA1c and SBP indicating increased risk of adverse clinical outcomes. IMPLICATIONS FOR PRACTICE: Improved management of cardiovascular risk factors in general, glycaemic control in particular, is central to addressing the increased risk of adverse outcomes in people with both SMI and T2DM. This article is protected by copyright. All rights reserved.