Diabetes patients die more frequently due to alcohol-related factors, accidents or suicide, new research has revealed.
A study published in the European Journal of Endocrinology suggests that the increased risk of death from these causes could be related to the mental health of patients due to the psychological burden of living with diabetes.
Researchers in Finland found that diabetes patients who needed regular self-injections of insulin would most likely die from these factors.
Everyone with type 1 and some people with type 2 diabetes need to inject insulin to manage their blood sugar levels.
About nine out of ten people with diabetes have Type 2 – which is related to an unhealthy lifestyle.
Since 1996, the number of people with diabetes in Britain has increased from 1.4 to 2.9 million. It is estimated that about one in seven adults will be affected by 2025 – around five million people.
The study authors said it is well known that diabetes patients are at higher risk of developing cardiovascular disease, cancer and kidney disease, leading to earlier death.
More recently, diabetes has been associated with an increased risk of depression, although it has not been studied how poor mental health affects patients with diabetes.
For their nationwide study, Professor Leo Niskanen and colleagues from the University of Helsinki, the University of Tampere, and the Helsinki University Hospital examined the causes of alcohol, suicide, or accident death among more than 400,000 people with or without diabetes.
Of the 434,629 individuals examined, 208,148 had diabetes.
The average follow-up was 7.1 years, with 2,832 alcohol-related deaths, 3,187 accidents, and 853 suicides.
The researchers found that diabetes was associated with higher mortality in almost all endpoints, especially in insulin-treated patients.
Prof. Niskanen said: "We know that living with diabetes can be a psychological burden.
"Monitoring your blood sugar levels and injecting insulin every day have a big impact on your daily life: simply eating, moving and sleeping all affect your blood sugar levels.
"This burden, combined with the fear of developing serious complications such as heart or kidney disease, can also affect mental well-being.
"This study has shown that people with diabetes need effective psychological support.
"If they feel they are under severe mental stress or if they think that their alcohol intake is excessive, they should not hesitate to discuss these issues with their family doctor.
"There are many ways to overcome these problems, provided they are communicated."