Cardiovascular risk management among individuals with type 2 diabetes and severe mental illness: a cohort study
Authors' conclusion
We found disparities in cholesterol target achievement and statin prescribing by SMI status. This reinforces the importance of clinical review of statin prescribing for secondary prevention of CVD, particularly among people with SMI.
Study context
- Population
- Adults diagnosed with T2D in Scotland 2004–2020; Severe mental illness (SMI) history from hospital admission records
- Participants
- 291,644 adults
- Exposure
- People with SMI vs without SMI
- Outcome
- Achievement of total cholesterol, systolic BP and HbA1c targets; receipt of statin prescription
- Follow-up
- 1 year after diabetes diagnosis (statin: at diagnosis and 1 year)
Methodological detailslinked electronic data, population-based (Scotland)
- Linked electronic data
- Population-based (Scotland)
Main finding
As reported in the abstract
Systolic BP target achievement · 1 year after diagnosis
Schizophrenia vs No SMIEstimate (95% CI)
Men
aOR 1.72(1.49–1.98)
Women
OR 1.64(1.38–1.96)
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Statin prescribing, prior CVD · at diabetes diagnosisSchizophreniavs No SMI | 0.54 (0.43–0.68) | |
| Statin prescribing, prior CVD · at diabetes diagnosisBipolar disordervs No SMI | 0.75 (0.56–1.01) | |
| Statin prescribing, prior CVD · at diabetes diagnosisMajor depressionvs No SMI | 0.92 (0.83–1.01) | |
| 0.512Odds ratio (log scale) |
Statin prescribing, no previous CVD · at diagnosis and 1 year later
- Statin prescribing similar or better with vs without SMI
Statin prescribing, prior CVD · at diabetes diagnosis
- Lower odds of statin prescribing with SMI generally persisted 1 year later
Original publication
Cardiovascular risk management among individuals with type 2 diabetes and severe mental illness: a cohort study. Diabetologia. Published 26 February 2024. doi:10.
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