BACKGROUND Individuals with schizophrenia often develop diabetes, but little is known about their risk of diabetic complications. We aimed to study incidence of registered diabetic complications and subsequent mortality in individuals with schizophrenia and diabetes compared to individuals with diabetes only. METHODS We conducted a cohort study using nationwide registers and followed all individuals in the entire Danish population diagnosed with diabetes from 1997 to 2017. Incidence rate ratios (IRR) of diabetic complications, all-cause and cause-specific mortality rate ratios (MRR) were estimated by Cox regression comparing individuals diagnosed with schizophrenia and diabetes to individuals diagnosed only with diabetes. RESULTS In a cohort of 239,118 individuals with diagnosed diabetes, the incidence of any diabetic complication was similar in females with schizophrenia and diabetes compared to females with diabetes only; IRR = 0.93 (95%CI: 0.84-1.02), and significantly lower in males; IRR = 0.85 (95%CI: 0.78-0.92). The all-cause mortality for individuals with a diagnosis of a diabetic complication was higher in individuals with schizophrenia and diabetes than in those with diabetes only; MRR = 1.92 (95%CI: 1.65-2.23) for females and MRR = 1.69 (95%CI: 1.49-1.92) for males. Among those without diabetic complications, schizophrenia was also associated with a higher mortality. CONCLUSIONS Individuals with schizophrenia and diabetes had similar or lower rates of diabetic complications, compared to those with diabetes only. Among those with diabetic complications, schizophrenia was associated with higher mortality. Similar, among those without diabetic complications, schizophrenia was also associated with higher mortality. Hence, diabetic complications do not seem to explain the excess mortality seen in individuals with schizophrenia.

中文翻译：

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精神分裂症和糖尿病患者的糖尿病并发症风险和随后的死亡风险——一项基于人群的登记研究

背景 精神分裂症患者通常会患上糖尿病，但人们对其发生糖尿病并发症的风险知之甚少。我们旨在研究与仅患有糖尿病的个体相比，患有精神分裂症和糖尿病的个体登记的糖尿病并发症的发生率和随后的死亡率。方法 我们使用全国登记册进行了一项队列研究，并跟踪了 1997 年至 2017 年诊断为糖尿病的整个丹麦人群中的所有个体。糖尿病并发症的发生率比 (IRR)、全因死亡率比 (MRR) 分别为通过 Cox 回归估计，将诊断为精神分裂症和糖尿病的个体与仅诊断为糖尿病的个体进行比较。结果 在由 239,118 名诊断为糖尿病的人组成的队列中，与仅患有糖尿病的女性相比，患有精神分裂症和糖尿病的女性的任何糖尿病并发症的发生率相似；IRR = 0.93 (95% CI: 0.84-1.02)，男性显着降低；IRR = 0.85（95% CI：0.78-0.92）。诊断为糖尿病并发症的个体的全因死亡率在精神分裂症和糖尿病个体中高于仅患有糖尿病的个体；女性的 MRR = 1.92（95%CI：1.65-2.23），男性的 MRR = 1.69（95%CI：1.49-1.92）。在没有糖尿病并发症的人群中，精神分裂症也与较高的死亡率有关。结论 与仅患有糖尿病的患者相比，患有精神分裂症和糖尿病的患者的糖尿病并发症发生率相似或更低。在患有糖尿病并发症的患者中，精神分裂症与较高的死亡率有关。相似的，在没有糖尿病并发症的人中，精神分裂症也与较高的死亡率有关。因此，糖尿病并发症似乎不能解释精神分裂症患者死亡率过高的原因。