The role of mental disorders in precision medicine for diabetes: a narrative review,Diabetologia

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The role of mental disorders in precision medicine for diabetes: a narrative review
Diabetologia ( IF 8.4 ) Pub Date : 2022-06-22 , DOI: 10.1007/s00125-022-05738-x
Sanne H M Kremers _{1,

2} , Sarah H Wild ₃ , Petra J M Elders _{2,

4} , Joline W J Beulens _{1,

2,

5} , David J T Campbell _{6,

7,

8} , Frans Pouwer _{9,

10,

11} , Nanna Lindekilde ₉ , Maartje de Wit _{2,

12} , Cathy Lloyd ₁₃ , Femke Rutters _{1,

2}

Affiliation

Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.
Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
General Practice, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, the Netherlands.
Department of Medicine, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Department of Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Department of Cardiac Sciences, University of Calgary Cumming School of Medicine, Calgary, AB, Canada.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.
School of Psychology, Deakin University, Geelong, Australia.
Medical Psychology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, Open University, Milton Keynes, UK.

This narrative review aims to examine the value of addressing mental disorders as part of the care of people with type 1 and type 2 diabetes in terms of four components of precision medicine. First, we review the empirical literature on the role of common mental disorders in the development and outcomes of diabetes (precision prevention and prognostics). We then review interventions that can address mental disorders in individuals with diabetes or at risk of diabetes (precision treatment) and highlight recent studies that have used novel methods to individualise interventions, in person and through applications, based on mental disorders. Additionally, we discuss the use of detailed assessment of mental disorders using, for example, mobile health technologies (precision monitoring). Finally, we discuss future directions in research and practice and challenges to addressing mental disorders as a factor in precision medicine for diabetes. This review shows that several mental disorders are associated with a higher risk of type 2 diabetes and its complications, while there is suggestive evidence indicating that treating some mental disorders could contribute to the prevention of diabetes and improve diabetes outcomes. Using technologically enabled solutions to identify mental disorders could help individuals who stand to benefit from particular treatments. However, there are considerable gaps in knowledge and several challenges to be met before we can stratify treatment recommendations based on mental disorders. Overall, this review demonstrates that addressing mental disorders as a facet of precision medicine could have considerable value for routine diabetes care and has the potential to improve diabetes outcomes.

Graphical abstract

中文翻译：

精神障碍在糖尿病精准医学中的作用：叙述性回顾

这篇叙述性综述旨在从精准医学的四个组成部分探讨将精神障碍作为 1 型和 2 型糖尿病患者护理的一部分的价值。首先，我们回顾了关于常见精神障碍在糖尿病发生和结果中的作用（精准预防和预后）的实证文献。然后，我们回顾了可以解决糖尿病患者或有糖尿病风险的人的精神障碍（精准治疗）的干预措施，并重点介绍了最近的研究，这些研究使用了新的方法，根据精神障碍，亲自或通过应用进行个体化干预。此外，我们还讨论了使用移动健康技术（精确监测）等对精神障碍进行详细评估的用途。最后，我们讨论了未来的研究和实践方向以及解决精神障碍作为糖尿病精准医学因素的挑战。本综述表明，多种精神障碍与 2 型糖尿病及其并发症的较高风险相关，同时有提示性证据表明，治疗某些精神障碍可能有助于预防糖尿病和改善糖尿病结局。使用技术解决方案来识别精神障碍可以帮助那些从特定治疗中受益的人。然而，在我们根据精神障碍对治疗建议进行分层之前，还存在相当大的知识差距和一些挑战。总体而言，本次综述表明，将精神障碍作为精准医学的一个方面，对于常规糖尿病护理具有相当大的价值，并且有可能改善糖尿病的预后。

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更新日期：2022-06-23

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