Background: People with severe mental illness (SMI) have a two to three-fold higher risk of developing diabetes. Mental healthcare providers have an important role in supporting people with SMI in diabetes management, but little is known about preferences for diabetes support among people with SMI and diabetes. The aim of the study was to explore the needs and preferences for diabetes support in this population.

Method: Semi-structured interviews were conducted with 15 adults with SMI and diabetes recruited from four psychiatric outpatient clinics in Denmark. Interviews were transcribed and analyzed using systematic text condensation.

Results: Participants’ mean age was 47 years, 40% were women, and 80% had T2DM. Mental health diagnoses included schizophrenia, bipolar disorder, severe depression, and personality disorder. Four main themes emerged in relation to support needs and preferences: 1) mental illness care significantly overshadowed diabetes care. It was difficult for people with SMI to prioritize diabetes management; 2) emotional state influenced diabetes management e.g., anxiety was linked to higher fat and sugar intake, and isolation lead to physical inactivity; 3) daily routines were experienced as difficult making diabetes routines even harder to perform, e.g., planning and preparing healthy meals and participating in routine diabetes health visits; 4) support from mental healthcare providers was perceived as crucial for managing diabetes for people with SMI. However, people with SMI experienced that the healthcare providers payed little attention to their physical health including their diabetes.

Conclusions: This study highlights difficulties of living with SMI and managing diabetes care. The results can facilitate the shaping of tailored interventions to support people with SMI in their diabetes management. Further studies are needed to develop and test relevant diabetes support for people with SMI and diabetes including training of mental healthcare providers.


V. Stenov: None. I. Willaing: None. L. Knudsen: None. D.L. Hansen: None. L.E. Joensen: None.

Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. More information is available at