Key result
Mental disorders in diabetes are linked to ~19% lower odds of adequate monitoring.
Why the study?
Does the presence of mental disorders reduce the quality of diabetes care and monitoring in people with diabetes?
Meta-Analysis
Does the presence of mental disorders reduce the quality of diabetes care and monitoring in people with diabetes?
Odds Ratio: 0.81 (95% CI 0.68–0.97)
p-value: p=0.024
Patients with diabetes and comorbid mental disorders receive significantly less adequate diabetes monitoring and are less likely to receive GLP-1 receptor agonists.
BACKGROUND: People with mental disorders have an increased risk of diabetes, yet conflicting evidence exists regarding the quality of diabetes care they receive. To address this evidence gap, we conducted a systematic review and meta-analysis to assess and compare diabetes quality of care in people with diabetes with mental disorders versus people with diabetes without mental disorders. METHODS: test, blood pressure measured, foot surveillance, serum creatinine test, serum cholesterol test, BMI recorded, smoking status recorded, retinal monitoring). Secondary outcomes were study-specific diabetes quality of care individual indicators matched to the nine NICE diabetes monitoring indicators and specific diabetes interventions and anti-diabetes medications. We analysed primary and secondary outcomes according to any mental disorder and to specific diagnostic subgroups. Study quality was evaluated using the Newcastle-Ottawa Scale (NOS). FINDINGS: measurement (24 studies, 0·81 [0·68-0·97], p=0·024), retinal screening (21 studies, 0·77 [0·63-0·95], p=0·013), lipid and cholesterol measurement (20 studies, 0·83 [0·69-0·99], p=0·043), foot examination (11 studies, 0·85 [0·76-0·95], p=0·0044), and renal investigation (16 studies, 0·78 [0·63-0·96], p=0·022). A significant positive association was found between any mental disorder and recorded smoking status (two studies, 1·09 [1·02-1·17]; p=0·0076). Any mental disorder was significantly associated with higher odds of receiving insulin (ten studies, 1·52 [95% CI 1·16-1·99]; p=0·0022), but negatively associated with treatment with a GLP-1 receptor agonist (two studies, 0·26 [0·13-0·49]; p<0·0001). There was no evidence of publication bias. INTERPRETATION: Mental disorders are negatively associated with receiving adequate diabetes monitoring and GLP-1 agonist therapy. Addressing these disparities has the potential to address the increased mortality associated with mental disorders.
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Wagner et al. (2026) conducted a meta-analysis in Diabetes with and without mental disorders. Mental disorders vs. No mental disorders was evaluated on Measurement (diabetes quality of care indicator) (OR 0.81, 95% CI 0.68-0.97, p=0.024). Mental disorders in patients with diabetes were negatively associated with receiving adequate diabetes monitoring, including measurement indicators (OR 0.81; 95% CI 0.68-0.97; p=0.024) and retinal screening.
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