Aims/hypothesis

Estimates of the global prevalence of type 2 diabetes vary between 6% and 9%. The prevalence of type 2 diabetes has been investigated in psychiatric populations but a critical appraisal of the existing evidence is lacking, and an overview is needed. This umbrella review summarises existing systematic reviews of observational studies investigating the prevalence of type 2 diabetes in people with a psychiatric disorder.

Methods

We searched PubMed, EMBASE, PsycINFO and the Cochrane Database of Systematic Reviews from inception to 17 January 2021 and screened reference lists of included systematic reviews. On the basis of prespecified criteria, we included systematic reviews investigating the prevalence of type 2 diabetes in adults (aged ≥18 years) with a psychiatric disorder. Titles and abstracts of 5155 identified records and full texts of 431 selected studies were screened by two independent reviewers, based on predefined eligibility criteria and an a priori developed extraction form, following the PRISMA and MOOSE guidelines. Risk of bias was assessed with the ROBIS instrument. Data extracted from primary studies were synthesised using random-effects meta-analyses.

Results

A total of 32 systematic reviews with 245 unique primary studies were identified and met inclusion criteria. Twelve had low risk of bias. They reported type 2 diabetes prevalence estimates ranging from 5% to 22% depending on the specific psychiatric disorder. We meta-analysed data for ten categories of psychiatric disorders and found the following prevalence estimates of type 2 diabetes: in people with a sleep disorder: 40%; binge eating disorder: 21%; substance use disorder: 16%; anxiety disorder: 14%; bipolar disorder: 11%; psychosis: 11%; schizophrenia: 10%; a mixed group of psychiatric disorders: 10%; depression: 9%; and in people with an intellectual disability 8%. All meta-analyses revealed high levels of heterogeneity.

Conclusions/interpretation

Type 2 diabetes is a common comorbidity in people with a psychiatric disorder. Future research should investigate whether routine screening for type 2 diabetes and subsequent prevention initiatives for these people are warranted.

PROSPERO registration no. CRD42020159870.

中文翻译：

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2 型糖尿病在精神疾病中的患病率：对来自 32 篇系统评价的 245 项观察性研究进行荟萃分析的综合评价

目标/假设

对全球 2 型糖尿病患病率的估计在 6% 和 9% 之间变化。已经在精神病人群中调查了 2 型糖尿病的患病率，但缺乏对现有证据的批判性评估，因此需要进行概述。这篇综述总结了现有的对观察性研究的系统评价，这些观察性研究调查了精神疾病患者 2 型糖尿病的患病率。

方法

我们检索了 PubMed、EMBASE、PsycINFO 和 Cochrane 系统评价数据库，检索时间为 2021 年 1 月 17 日，并筛选了纳入系统评价的参考文献列表。根据预先设定的标准，我们纳入了系统评价，调查患有精神疾病的成人（≥18 岁）中 2 型糖尿病的患病率。根据 PRISMA 和 MOOSE 指南，根据预定义的资格标准和先验开发的提取表格，两位独立评审员筛选了 5155 条已确定记录的标题和摘要以及 431 项选定研究的全文。使用 ROBIS 工具评估偏倚风险。使用随机效应荟萃分析综合了从主要研究中提取的数据。

结果

共有 32 篇系统评价和 245 项独特的主要研究被确定并符合纳入标准。12 人的偏倚风险较低。他们报告了 2 型糖尿病患病率估计范围为 5% 至 22%，具体取决于特定的精神疾病。我们对十类精神疾病的数据进行荟萃分析，发现以下 2 型糖尿病患病率估计值： 睡眠障碍患者：40%；暴食症：21%；物质使用障碍：16%；焦虑症：14%；双相情感障碍：11%；精神病：11%；精神分裂症：10%；混合型精神疾病：10%；抑郁症：9%；在智障人士中为 8%。所有荟萃分析均显示高度异质性。

结论/解释

2 型糖尿病是精神疾病患者的常见合并症。未来的研究应调查是否有必要对这些人进行 2 型糖尿病的常规筛查和随后的预防措施。

PROSPERO 注册号 CRD42020159870。