Diabetes Screening Among Underserved Adults With Severe Mental Illness Who Take Antipsychotic Medications.

Diabetes Screening AmongUnderservedAdults With SevereMental IllnessWho Take AntipsychoticMedications Adults in the United States with severe mental illness (SMI), such as schizophrenia and bipolar disorder (totaling approximately 7 million), are estimated to die, on average, 25 years earlier than thegeneralpopulation, largely of premature cardiovascular disease.1 The Institute of Medicine2 has called for improvements in health care for this population. Severemental illness is associatedwith elevated risk for type 2 diabetes mellitus.3 Treatment with antipsychotic medications contributes to risk, withmost evidence focused on second-generation antipsychotic medications, but similar increases in riskare reportedwitholderandnewermedications.4 TheAmericanDiabetesAssociation5 recommends annual diabetes screening for patients treatedwith antipsychoticmedications, and public health administrators have targeted this population for improvedhealth screening.6Toourknowledge, no studies have examined screening rates in this highest-risk population of adults with SMI because of limitations in public health medical records. We examined diabetes screening among publicly insured adults with SMI taking antipsychotic medications using matched administrative data for physical andmental health care services in a large health care system. We measured diabetes screening prevalence among patients with SMI treated with antipsychotic medications and assessed characteristics predictive of screening.