Evidence map›Paper›PMID 41235789›Full record

ArticleDiabetes, obesity & metabolism2026

Prescribing of glucose-lowering medication to adults with type 2 diabetes by severe mental illness status in Scotland: A cohort study.

Jilly Adams, Shuvajit Saha, Kelly J Fleetwood, Luke A K Blackbourn, Stuart J McGurnaghan, Sarah H Wild, Caroline A Jackson, Scottish Diabetes Research Network Epidemiology Group

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Article in Diabetes, obesity & metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Jilly AdamsUsher Institute, University of Edinburgh, Edinburgh, UK.
Shuvajit SahaUsher Institute, University of Edinburgh, Edinburgh, UK.
Kelly J FleetwoodUsher Institute, University of Edinburgh, Edinburgh, UK.
Luke A K BlackbournMRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.
Stuart J McGurnaghanMRC Institute of Genetics and Cancer, University of Edinburgh, Edinburgh, UK.
Sarah H WildUsher Institute, University of Edinburgh, Edinburgh, UK.
Caroline A JacksonUsher Institute, University of Edinburgh, Edinburgh, UK.ORCID https://orcid.org/0000-0002-2067-2811
Scottish Diabetes Research Network Epidemiology Group

Funding

UKRI MR/Z000548/1UKRI MR/Z503563/1
6 · The paper itself

Abstract

aimWe aimed to determine whether glucose-lowering medication (GLM) prescribing differs by severe mental illness (SMI) status. MATERIALS AND

methodsWe conducted a population-based cohort study using routinely collected linked data, including people in Scotland diagnosed with type 2 diabetes between January 2004 and March 2022. We used Cox proportional hazards models to compare the time from diabetes diagnosis to the first prescription of each of metformin and insulin in people with and without a hospital admission record of SMI (schizophrenia, bipolar disorder or depression prior to diabetes diagnosis). We adjusted for age, sex, area-based socio-economic deprivation, smoking status and baseline HbA1c and estimated glomerular filtration rate.

resultsAmong 317 761 people with type 2 diabetes, 14 600 (4.6%) had pre-existing SMI. During a median follow-up of 1.6 years, 10 859 (74%) of those with SMI and 219 823 (73%) without SMI were prescribed metformin. After accounting for confounders, people with SMI received their first metformin (HR 1.09, 95% CI: 1.07-1.11) and insulin (HR 1.24, 95% CI: 1.18-1.31) prescriptions at a faster rate than people without SMI. Body mass index (BMI) was missing in 21% of participants, but similar estimates were obtained when we additionally adjusted for BMI in analyses that only included people with BMI data.

conclusionsAmong people with type 2 diabetes each of metformin and insulin is prescribed sooner in people with compared to those without SMI. Further research is needed to understand the reasons for this, and to investigate the implications of these differences in prescribing patterns.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsMental DisordersPractice Patterns, Physicians'AdultAgedCohort StudiesDrug PrescriptionsFemaleHumansInsulinMaleMetforminMiddle AgedScotlandHypoglycemic AgentsInsulinMetforminbipolar disordercohort studydepressiondiabetesglucose‐lowering medicationinsulinmetforminschizophreniasevere mental illness

Identifiers

PMID41235789
PMCPMC12803641

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