Mental Health Comorbidity Is Common in Children With Type 2 Diabetes

Abstract

Background: to describe the prevalence of mental health comorbidity in children with type 2 diabetes compared to a matched population without diabetes and children with type 1 diabetes. Methods: Population-based cohorts of 528 youth (7–18 years of age) with prevalent type 2 diabetes, 1519 matched children without diabetes and 778 youth with type 1 diabetes were identified from a clinical registry and linked to health care records to assess the prevalence of mental health comorbidity using ICD-9CM, ICD-10CA and ATC codes. Findings: Compared to their matched peers, children with type 2 diabetes where more likely to have a mood or anxiety disorder before and after diagnosis [RR 2‧38 (1‧63, 3‧48) p<0‧001 and 1 ‧70(1‧39, 2‧08) p< 0‧001 respectively], to attempt/complete suicide [RR 3‧18 (1‧30, 7‧81) p=0‧012 and 2‧18 (1.32, 3‧60) p=0‧0002 respectively] and be prescribed an antipsychotic [RR 2‧33 (1‧23, 4‧39) p= 0‧009 and 1‧76 (1‧23, 2‧52) p=0‧002 respectively]. Children with type 2 diabetes, compared to children with type 1 diabetes where more likely to have a mood or anxiety disorder, substance abuse and be prescribed an antipsychotic after diagnosis [2‧34 (1‧85, 2‧96) p<0‧0001; RR 2‧70 (1‧46, 4‧99) p=0‧002; RR 5‧60 (3‧08, 10‧17) p<0‧0001respectively]. Interpretation: Children with type 2 diabetes have high rates of comorbid mental illness. Programs to provide care, support and education to children with type 2 diabetes must address the mental health comorbidity in the context of the demographic, socioeconomic and psycho-cultural characteristics of the population. Funding Statement: Manitoba Government Department of Health. Declaration of Interests: None of the authors declare any conflicts of interest relevant to this article. Ethics Approval Statement: First Nations Research File was used with the permission of the Health information Research Goverance Committee of First Nations Health and Social Secretariat of Manitoba (FNHSSM). The DER-CA gave permission for use of their database in an anonymized form. Approvals were also obtained from the Health Research Ethics Board, University of Manitoba and the Manitoba Health Information Privacy Committee.