• Murrium I Sadaf, Marie Caldwell, Laura A Young, Mojtaba Mirzaei, Sarah Chen, Golsa Joodi, Feng-Chang Lin, Yunhan Wu, and Ross J Simpson.
• From the Department of Internal Medicine, Yale-New Haven Medical Center, Waterbury, Connecticut, the Department of Medicine, Division of Endocrinology, Maine Medical Partners Endocrinology & Diabetes Center, Scarborough, Maine, the Department of Medicine, Division of Endocrinology, University of North Carolina, Chapel Hill, the Department of Medicine, Division of Cardiology, University of North Carolina, Chapel Hill, the Division of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, and the Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill.
• South. Med. J. 2021 Feb 1; 114 (2): 86-91.

ObjectivesDiabetes mellitus (DM) increases the risk of cardiovascular disease and is associated with sudden death. Mental illness among individuals with DM may confound medical care. This study assessed the association of mental illness with DM and poorly controlled DM in sudden death victims.MethodsWe screened out-of-hospital deaths ages 18 to 64 years in Wake County, North Carolina from 2013 to 2015 to adjudicate sudden deaths. We abstracted demographics and clinical characteristics from health records. Mental illness included anxiety, schizophrenia, bipolar disorder, or depression. Poorly controlled DM was defined as a hemoglobin A1c >8 or taking ≥3 medications for glycemic control. Logistic regression assessed the association between DM and mental illness.ResultsAmong victims with available records, 109 (29.4%) had DM. Of those, 62 (56.9%) had mental illness. Mental illness was present in 53.42% and 63.89% of victims with mild and poorly controlled DM, respectively. Mental illness was associated with DM (adjusted odds ratio 2.46, 95% confidence interval 1.57-3.91). Victims with poorly controlled DM were more likely to have mental illness (adjusted odds ratio 2.66, 95% confidence interval 1.14-6.18).ConclusionsDM is a common comorbid condition in sudden death victims. Among victims, mental illness is associated with the control of DM. Early management of comorbid mental illnesses may improve the care of patients with DM and reduce the incidence of sudden death.

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