Mental health treatment could be key to reducing hospital admissions and time spent in hospital for severe diabetes patients, according to the first UK trial of its kind conducted at a London hospital.
A study by consultants at Barts Health NHS Trust and East London Foundation Trust found that mental health interventions could significantly reduce the chance of hospital admission in patients with recurrent diabetic ketoacidosis (DKA), a life-threatening complication of diabetes.
Previous research has indicated a direct link between DKA and depression, anxiety and eating disorders. DKA occurs in people with Type 1 diabetes if their body starts to run out of insulin and can be fatal. It is the leading cause of death from Type I diabetes for people aged under 30.
For the study, clinicians assessed 20 patients aged between 22-37 with type 1 diabetes, all of whom had attended hospital with diabetes-related issues in the past year. All patients had previously been diagnosed with at least one mental health condition.
Each patient was then offered between 12-18 months of specialist treatment: including medication, therapy and wider support with benefits and housing.
The trial saw a 20 per cent fall in admissions among those at high risk of DKA and a 50 per cent reduction in bed days.
An estimated 125 bed days were also saved over a 12-month period, saving more than £159,000.
Dr Chris Garrett, a consultant diabetes psychiatrist at Barts, who led the trial, told the Standard that better coordination between mental health and diabetes care could vastly improve outcomes for patients.
“If your glucoses are high, it impacts your concentration and your mood. The same can apply in the other direction: if you feel low for a while it can affect how you look after your diabetes.”
Many patients he treated had spoken of what is known among clinicians as “diabetes distress”, he said, referring to the term where a patient feels overwhelmed and defeated by the condition.
“A lot of patients feel a heightened anxiety around the complications. It also gets in the way of friendships with loved ones, and they don’t feel supported.”
He said he would like to see the project rolled out in further NHS trusts.
