Ethnic Differences in the Prevalence of Mental Health Disorders Among Individuals with Diabetes: A Systematic Review and Meta-analysis.
Ngozika Esther Ezinne, Kingsley Emwinyore Agho, Aunty Kerrie Doyle et al.
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In 30 seconds
This systematic review and random-effects meta-analysis examined mental health disorder prevalence among adults with diabetes, synthesising 53 observational studies published in English between 2014 and 2024. The pooled prevalence was 25.78% (95% CI: 23.27-28.29), with substantial heterogeneity (I 2 = 99.9%). Among groups with reported ethnicity, prevalence was highest in North Africa and the Middle East (32.44%, 95% CI: 27.71-37.45) and lowest among Oceanians (10.42%). The authors also found variation by diabetes type, diagnostic method, country income level, and Indigenous status.
Key findings
- Pooled mental health disorder prevalence was 25.78% (95% CI: 23.27-28.29); heterogeneity was high (I 2 = 99.9%).
- Prevalence was 32.44% (95% CI: 27.71-37.45) in North Africa and the Middle East, versus 10.42% among Oceanians.
- PTSD (37.79%) and depression (27.55%) were the most common disorders; schizophrenia was least prevalent (3.45%).
- Prevalence was higher in low-income countries (40.63%) and non-Indigenous populations (26.45%) than Indigenous groups (17.65%).
Why it matters
The findings indicate that mental health disorders are common among adults with diabetes, while pooled prevalence varies across ethnic and socioeconomic contexts. This variation can help inform assessment of mental health needs and highlights the importance of interpreting prevalence estimates in light of population characteristics and the substantial between-study heterogeneity.
What to keep in mind
The pooled estimate had very high heterogeneity (I 2 = 99.9%), limiting how uniformly it may represent different populations. The review included observational studies, so reported subgroup differences do not establish causes.