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Psychiatric disorders as risk factors for the development of type 2 diabetes mellitus: an umbrella review protocol
  1. Nanna Lindekilde1,
  2. Giesje Nefs2,3,
  3. Jan Erik Henriksen4,
  4. Mathias Lasgaard1,5,
  5. Miranda Schram6,
  6. Katrine Rubin7,
  7. Femke Rutters8,
  8. Mika Kivimaki9,
  9. Frans Pouwer1,4
  1. 1 Department of Psychology, University of Southern Denmark, Odense, Denmark
  2. 2 Diabeter, National Treatment and Research Center for Children, Adolescents and Young Adults with Type 1 Diabetes, Rotterdam, The Netherlands
  3. 3 Department of Medical Psychology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
  4. 4 Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
  5. 5 DEFACTUM Public Health & Health Services Research, Central Denmark Region, Aarhus, Denmark
  6. 6 Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
  7. 7 Odense Patient Data Explorative Network (OPEN), Department of Clinical Research, University of Southern Denmark and Odense University Hospital, Odense, Denmark
  8. 8 Department of Epidemiology and Biostatistics, Faculty of Medicine, Amsterdam UMC, Amsterdam, The Netherlands
  9. 9 Department of Epidemiology and Public Health, University of College London, London, UK
  1. Correspondence to Nanna Lindekilde; nlindekilde{at}


Introduction Numerous longitudinal studies, systematic reviews and meta-analyses have examined psychiatric disorders as risk factors for the development of type 2 diabetes mellitus. A more comprehensive overview of the area is warranted to summarise current evidence and discuss strengths and weaknesses to guide future research.

Aim The aim of this umbrella review is to determine whether and to what extent different psychiatric disorders are associated with the development of type 2 diabetes mellitus. Furthermore, the umbrella review also assesses the evidence on potential mediating mechanisms.

Methods and analysis The present umbrella review will consist of a comprehensive systematic search of published systematic reviews and meta-analyses of observational longitudinal studies investigating whether a psychiatric disorder is associated with the risk of developing type 2 diabetes. PubMed, Embase, PsychINFO and the Cochrane Database of Systematic Reviews will be searched, and the results will be screened for inclusion by two independent reviewers. Furthermore, the reference lists of included publications will be manually searched. Two independent reviewers will extract data and assess the methodological quality in the included systematic reviews and meta-analyses. Evidence on potential mediating mechanisms included in the systematic reviews and meta-analyses will also be reviewed. The implications of the overview will be discussed in light of the quality of the included studies, and suggestions for clinical practice and future research will be made.

Ethics and dissemination Ethical approval is not required for this umbrella review. Our review will be submitted for publication in a peer-reviewed international journal using open access option if available. The results will also be disseminated at international conferences.

PROSPERO registration number CRD42018096362

  • mental disorders
  • diabetes mellitus
  • umbrella review
  • risk factors

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors FP is guarantor of the umbrella review. FP and NL had the original idea and designed the study with critical contributions from JEH and ML. NL wrote the first draft of the protocol and submitted the registration to PROSPERO. All authors (NL, GN, JEH, ML, MS, KHR, FR, MK and FP) have contributed to the manuscript and approved the final revised version of the manuscript that was resubmitted for publication.

  • Funding This work was supported by an unrestricted grant from the Faculty of Health Sciences, University of Southern Denmark, to FP. The financial provider is not involved in any other aspect of the project neither planning the design, data collection, analyses or interpretation of the results. MK is supported by the Medical Research Council (K013351, R024227 and S011676), NordForsk, Academy of Finland (311492) and a Helsinki Institute of Life Science fellowship.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Not required.

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