Mental Health Disparities Observed in People with Diabetes Across Europe

Mental health disparities by nationality, gender, and age among people with type 1 and type 2 diabetes from six countries in Europe were uncovered in new findings.

The data suggest a relationship between glycemic management and the severity of generalized anxiety disorder (GAD) in this patient population with diabetes.

“This underscores the need for a more integrated approach to diabetes management and mental health support to both minimize anxiety and improve blood sugar metrics targeted at high-risk groups,” said Evelyn Cox, dQ&A, The Diabetes Research Company in an accompanying statement.

The research was presented at the European Association for the Study of Diabetes Annual Meeting 2022 in Stockholm, Sweden.

According to prior research, higher rates of mental health disorders have been linked to diabetes diagnosis, compared with the general population. Support from therapy for psychiatric medication may be effective in addressing mental health concerns for these people, but there is little research on the relationship between diabetes management and anxiety.

The investigators conducted an online survey to collect data on demographic characteristics, anxiety, and blood sugar management metrics in 3,077 adults living with diabetes in France, Germany, Italy, Netherlands, Sweden, and the United Kingdom.

These people reported their most recent HbA1c if they knew it (n = 2,561). Glucose sensor users (n = 2,011) also reported the percentage of time in a typical day spent in the target range (Time-in-range [TIR], 70 - 190 mg/dL).

All people were required to complete the 7-item validated measure to assess severity of GAD (GAD-7). Subsequent responses (66% type 1, 52% female) were scored and analyzed

Findings from the analysis reported that people with diabetes living in Italy and the United Kingdom had the highest rates of anxiety (63% and 51%, respectively). Individuals in the Netherlands reported the lowest rates (39%).

Women with diabetes were more likely to report experiencing anxiety than men with diabetes across all European countries studied (57% vs 39%; P <.001). Adults under 45 years of age saw more prevalence in diabetes than those 45 years and above (59% and 34%; P <.001).

Higher HbA1c (≥7%) was linked to significantly greater likelihood of moderate (13% vs. 10%; P = .03) or severe anxiety (6% vs 4%; P = .04) compared with lower HbA1c (≤7%).

Individuals using glucose sensors with time-in-range under 70% have significantly higher rates of moderate or severe anxiety relative to those who spend 70% or more of time in target range (22% vs 14%; P <.001).

“It is crucial that people with diabetes who experience challenges with their mental health reach out to their healthcare providers or mental healthcare practitioners for support”, Cox concluded. “Effective treatments are available and can considerably improve quality of life.”

The abstract, “Associations between generalized anxiety disorder, glycemic management, and demographic factors among adults with diabetes in Europe,” was presented at EASD Stockholm 2022.