France: Study on Young Adults with Type 1 Diabetes and Suicide Risk

Young adults with type 1 diabetes (T1D) hospitalized for diabetic ketoacidosis have an increased tendency for a suicide attempt, particularly within 12 months from the index hospitalization, suggests a recent study. Findings of the study, published in the journal Diabetologia, are significant for guiding efforts for reducing suicide attempt risk in this population.

Jean-Michel Petit, Dijon University Hospital, Dijon Cedex, France, and colleagues aimed to examine the associations between hospitalization for diabetic ketoacidosis and subsequent hospitalization for suicide attempts in young adults with T1D.

This study included hospital data on all young people who were hospitalized in France in 2008 for type 1 diabetes. Epidemiological follow-up focused on hospitalizations (medical and psychiatric hospital data) from the index hospitalization to 2017. Cox proportional hazards regression model was used to explore the association between hospitalization for ketoacidosis and subsequent hospitalization for a suicide attempt.

Key Findings of the Study

• In 2008, 16,431 people aged 18–35 years had a hospitalization mentioning type 1 diabetes. Among them, 1539 (9.4%) had at least one hospitalization for ketoacidosis between 2008 and 2010.
• At 9 years, 7.2% of the group hospitalized for ketoacidosis had been hospitalized for a suicide attempt vs only 2.5% in the group not hospitalized for ketoacidosis.
• The association between hospitalization for ketoacidosis and suicide attempt decreased over time and was no longer significant after 5 years.

"We found that young adults admitted to hospital for diabetic ketoacidosis have an increased risk of being admitted to hospital for a subsequent suicide attempt. The risk of a suicide attempt was the highest in the 12 months following the ketoacidosis episode," wrote the authors.

"Our findings support the recommendation that screening for depression and suicide risk should be part of the routine clinical assessment of individuals with type 1 diabetes and ketoacidosis," they concluded.

The study, "Association between hospital admission for ketoacidosis and subsequent suicide attempt in young adults with type 1 diabetes," is published in the journal Diabetologia.

DOI: https://doi.org/10.1007/s00125-020-05206-4