Abstract
Psychiatric disorders and diabetes are problems that frequently overlap in psychiatric and primary care settings. Those patients with psychiatric disorders and/or social problems have a higher incidence of diabetes complications and poor outcomes (Knudsen, et al., 2022). Clinician awareness of the person's diabetes health with measures to identify and support them, may reduce their risk of developing complications of Type 2 Diabetes Mellitus (T2DM). The purpose of this presentation is to address early identification and interventions to prevent complications of T2DM, and the importance of collaboration with diabetic care specialists among patients receiving psychiatric care. Diabetes and psychiatric disorders can present when psychiatric disorders are associated with the chronicity and complexities of living with diabetes and as adverse metabolic effects associated with weight gain from antipsychotics and some other psychiatric medications.
The healthcare team aiding in diabetic management should include those who specialize in diabetes, including physicians, nurse practitioners, physician assistants, nurses, dietitians, exercise specialists, pharmacists, dentists, podiatrists, and mental health professional (American Diabetes Association Practice Committee, 2024). Factors to consider include A1c goals, efficacy, cost, side effects, contraindications, adherence, comorbidities, mechanisms of action, and non-glycemic effects on atherosclerotic cardiovascular disease, obesity, congestive heart failure, and chronic kidney disease (ElSayed et al., 2023; Schroeder, 2022).
In the psychiatric setting, clinicians can provide intensive behavioral counseling interventions to promote a healthful diet, physical activity, and weight loss. Considering side effects including weight-gain of antipsychotics and antidepressants, should be considered in prescribing pharmacological therapies, when treating acute psychiatric presentations (McIntyre et al., 2024).
Metformin should be considered in those with prediabetes, especially with a BMI ≥35 kg/m2, those aged <60 years, and women with prior gestational diabetes mellitus (American Diabetes Association Professional Practice Committee, 2024). For T2DM, glucagon-like peptide 1 receptor agonist (GLP-1 RA), and/or sodium–glucose cotransporter 2 inhibitor (SGLT-2) may be considered as first line agents instead of metformin, considering the atherosclerotic cardiovascular, heart failure, and chronic kidney disease benefits.
Notes
References:
American Diabetes Association Professional Practice Committee (2024). 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2024. Diabetes care, 47(Suppl 1), S158–S178. https://doi.org/10.2337/dc24-S009
ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Das, S. R., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Kosiborod, M., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., … American Diabetes Association (2023). Erratum. 10. Cardiovascular disease and risk management: Standards of Care in Diabetes-2023. Diabetes Care 2023;46(Suppl. 1):S158-S190. Diabetes care, 46(4), 898. https://doi.org/10.2337/dc23-er04
McIntyre, R. S., Kwan, A. T. H., Rosenblat, J. D., Teopiz, K. M., & Mansur, R. B. (2024). Psychotropic drug-related weight gain and its treatment. The American Journal of Psychiatry, 181(1), 26–38. https://doi.org/10.1176/appi.ajp.20230922
Knudsen, L., Hansen, D. L., Joensen, L. E., Wibaek, R., Benros, M. E., Jørgensen, M. E., & Andersen, G. S. (2022). Need for improved diabetes support among people with psychiatric disorders and diabetes treated in psychiatric outpatient clinics: results from a Danish cross-sectional study. BMJ open diabetes research & care, 10(1), e002366. https://doi.org/10.1136/bmjdrc-2021-002366
Schroeder, E. B. (2022). Management of Type 2 Diabetes: Selecting Amongst Available Pharmacological Agents. In K. R. Feingold (Eds.) et. al., Endotext. MDText.com, Inc.
Sigma Membership
Tau
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Public and Community health, Interprofessional Initiatives, Competence, Psychiatric Disorders, Diabetes, Type 2 Diabetes
Recommended Citation
Arceneaux, Leslie S. and Kverno, Karan, "Collaborative Care Integration for Improving Outcomes With Type 2 Diabetes and Psychiatric Disease" (2025). International Nursing Research Congress (INRC). 49.
https://www.sigmarepository.org/inrc/2025/presentations_2025/49
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Collaborative Care Integration for Improving Outcomes With Type 2 Diabetes and Psychiatric Disease
Seattle, Washington, USA
Psychiatric disorders and diabetes are problems that frequently overlap in psychiatric and primary care settings. Those patients with psychiatric disorders and/or social problems have a higher incidence of diabetes complications and poor outcomes (Knudsen, et al., 2022). Clinician awareness of the person's diabetes health with measures to identify and support them, may reduce their risk of developing complications of Type 2 Diabetes Mellitus (T2DM). The purpose of this presentation is to address early identification and interventions to prevent complications of T2DM, and the importance of collaboration with diabetic care specialists among patients receiving psychiatric care. Diabetes and psychiatric disorders can present when psychiatric disorders are associated with the chronicity and complexities of living with diabetes and as adverse metabolic effects associated with weight gain from antipsychotics and some other psychiatric medications.
The healthcare team aiding in diabetic management should include those who specialize in diabetes, including physicians, nurse practitioners, physician assistants, nurses, dietitians, exercise specialists, pharmacists, dentists, podiatrists, and mental health professional (American Diabetes Association Practice Committee, 2024). Factors to consider include A1c goals, efficacy, cost, side effects, contraindications, adherence, comorbidities, mechanisms of action, and non-glycemic effects on atherosclerotic cardiovascular disease, obesity, congestive heart failure, and chronic kidney disease (ElSayed et al., 2023; Schroeder, 2022).
In the psychiatric setting, clinicians can provide intensive behavioral counseling interventions to promote a healthful diet, physical activity, and weight loss. Considering side effects including weight-gain of antipsychotics and antidepressants, should be considered in prescribing pharmacological therapies, when treating acute psychiatric presentations (McIntyre et al., 2024).
Metformin should be considered in those with prediabetes, especially with a BMI ≥35 kg/m2, those aged <60 >years, and women with prior gestational diabetes mellitus (American Diabetes Association Professional Practice Committee, 2024). For T2DM, glucagon-like peptide 1 receptor agonist (GLP-1 RA), and/or sodium–glucose cotransporter 2 inhibitor (SGLT-2) may be considered as first line agents instead of metformin, considering the atherosclerotic cardiovascular, heart failure, and chronic kidney disease benefits.
Description
In psychiatric care settings, prevention of T2DM requires promotion of healthy behaviors in addition to careful choices in treating psychiatric disorders that require medication. Early identification and treatment of those with prediabetes should include referral to diabetic care specialists. Collaboration between psychiatric–mental health nurse practitioners and primary care nurse practitioners who are Certified Diabetes Care Education Specialists, is especially beneficial to patients at risk.