23 May 2012
Patients with diabetes who are struggling to manage their glucose levels should be screened for mental illness in general practice, warns a leading psychiatrist.
Speaking at the RANZCP conference in Hobart, Dr Carol Silberberg said that GPs needed to be aware of the "crossovers" between diabetes and mental health and should have a "high end of suspicion" when treating patients with unexplained poor glycaemic control as they could have a psychiatric illness.
And some adolescents, particularly females, are even skipping their insulin dose because they are battling with an eating disorder, she said.
Dr Silberberg who works at St Vincent's Hospital in Melbourne said there were a number of psychiatric disorders associated with diabetes including depression, anxiety and eating disorders.
She suggested patients with poor glycaemic control could be screened for depression in primary care and that doctors should be asking whether their patients are skipping their insulin dose to control their weight, with evidence showing that adolescents with diabetes are twice as likely to have an eating disorder than those without the disease.
People across the board are answering in the affirmative to that screening question, she said.
"When you see patients that have high HbA1c levels I am saying don't just assume they are struggling to look after their diabetes properly it may be that they are suffering from some kind of mental illness...And if that is treated it could help in their overall management of diabetes", Dr Silberberg said.
"We know that patients with depression have worse diabetes outcomes and patients with diabetes and mental health problems have worse mental health outcomes so we are trying to lower both the clinical burden and the public health burden."
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