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Chapter 13 - Service- and Setting-Related Challenges

Residential Care and Inpatient Settings

Published online by Cambridge University Press:  14 October 2021

Anne M. Doherty
Affiliation:
University College Dublin
Aoife M. Egan
Affiliation:
Division of Endocrinology and Metabolism, Mayo Clinic, Minnesota, USA
Sean Dinneen
Affiliation:
School of Medicine, National University of Ireland, Galway
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Summary

Given the high rates of diabetes being comorbid with many mental health conditions, it is no surprise that diabetes is very common in mental health facilities and settings. When the mortality gap in severe mental illness is considered, along with the fact that cardiovascular diseases (including diabetes as a cardiovascular risk factor) contribute greatly to this mortality gap, the importance of acting to reduce the impact of suboptimally managed diabetes in these settings is clear. Specific measures may be required to ensure that patients in these settings receive the usual standard of care. Factors such as acuity of illness, lack of insight into both mental and physical health problems and practical difficulties in attending appointments may mitigate against optimised diabetes management. This chapter considers specific challenges particular to various settings, and we will consider some measures that may help to ameliorate or fully overcome these barriers to optimised care. We will consider specific measures in various types of residential units and other settings (including inpatient settings), and we will explore different initiatives that have been used to overcome these challenges and close the mortality gap

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Publisher: Cambridge University Press
Print publication year: 2021

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