Patient Care

Serious Mental Illness and Its Impact on Diabetes Care in a VA Nurse/Pharmacist-Managed Population

Collaboration between a registered nurse-certified diabetes educator and clinical pharmacy specialist improved access to care and glycemic control in veterans with diabetes and mental illness.

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Diabetes mellitus (DM) is considered one of the most psychologically and behaviorally demanding chronic medical conditions. Patients with DM and serious mental illness (SMI), including schizophrenia, schizoaffective disorder, major depressive disorder (MDD), and bipolar disorder, are more likely to have poor adherence to medications as well as poor adherence to diet and lifestyle recommendations, which can lead to poor glycemic control, decreased quality of life, and increased health care expenses. 1-4 Up to 27% of patients with DM have a depression diagnosis, and up to 60% of patients with DM experience depressive symptoms. 5 Additionally, 1 in 4 patients with schizophrenia have a DM diagnosis. 6 Serious mental illness can compromise DM self-management and glycemic control, which increases the risk of DM-related complications. 7

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