Summary
Authors investigate whether the association between diabetes and suicide risk varies by area-level deprivation. They conducted a matched-pair cohort study using a nationwide health insurance database in Japan. Individuals with diabetes were matched 1:1 with those without diabetes by age, sex, and insurance status (i.e., insured person or their dependents). Area-level deprivation was assessed with a census-based Areal Deprivation Index (ADI). A Cox proportional hazards model was used to estimate the hazard ratio (HR) and 95% confidence interval (CI) of suicide for individuals with diabetes by area-level deprivation level.
Findings: Among 5,31 million individuals (54.8% men, mean age 52.9 years), we observed 760 suicides. Individuals with diabetes experienced a higher risk of suicide than those without diabetes. The association between diabetes and suicide was stronger in less deprived areas than more deprived areas. Findings suggest greater psychosocial challenges of diabetes diagnosis and management faced by individuals living in less deprived areas, or a possibility that diabetes diagnosis may reduce disparities by improving healthcare access in more deprived areas.