Results: Background: To assess the impact of bipolar condition on diabetes care.
Methods: We identified 142 adults with diabetes mellitus and bipolar condition and 14,002 adults with diabetes and no evidence of bipolar condition. Patients were categorized as having bipolar if one or more ICD-9 diagnosis codes for bipolar condition existed in a 24 month period. We compared patterns of diabetes care in both groups, including frequency of glycated hemoglobin (A1c) testing, A1c values among those tested, and number of medical outpatient visits. Multivariate linear regression predicted A1c values adjusting for patient covariates including age, gender, Charlson comorbidity score, number of primary care visits and likelihood of an A1c test.
Results: Compared to diabetes patients without bipolar, those with bipolar were significantly younger (mean age 54.8 vs. 61.1 years, p<.0001), more likely to be female (66.2 % vs. 47.9 %, p<.0001), had similar medical comorbidity (19.7% vs. 15.3%, Charlson score = 1, p=.15), and more primary care visits (10.3 vs. 6.9, p<.0001). Those with bipolar had significantly lower rates of A1c testing (59.2% vs. 70.5 %, p=.003) in a 6 month period. Among those with an A1c test, unadjusted mean A1c was 7.4% in bipolar and 7.7% in non-bipolar patients (p=.11). After adjustment for age, gender, comorbidity score, number of visits and A1c test likelihood, those with bipolar had significantly better A1c levels than those without bipolar (p<.005).
Conclusion: Adults with diabetes and bipolar h ad more medical visits and fewer A1c tests. We found no evidence that bipolar condition is associated with worse glycemic control.