# A Systematic Review of Treatment Approaches for Individuals With Coexisting Diabetes and Substance Use Disorder

## TL;DR

This review examines treatment strategies for people with both diabetes and substance use disorder, highlighting the need for integrated care.

## Contribution

The paper systematically reviews current treatment approaches for coexisting diabetes and SUD, emphasizing gaps in integrated care.

## Key findings

- Pharmacotherapies like semaglutide and buprenorphine-naloxone are used, but often address diabetes and SUD separately.
- Behavioral therapies, such as mindfulness, are underutilized despite their potential for this population.
- Integrated care models are needed to effectively manage both conditions simultaneously.

## Abstract

Diabetes is a chronic metabolic disease that is widespread and has negative consequences for health and well-being. Substance use disorder (SUD) is characterized by the uncontrolled use of substances, including tobacco, alcohol, marijuana, and illicit drugs, leading to impaired mental and physical health. Individuals with coexisting diabetes and SUD experience exacerbated consequences, including increased susceptibility to diabetes-related complications, hospitalizations, and mortality. Additionally, this unique population utilizes significant hospital resources, leading to a burden on the healthcare system. This systematic review is designed to synthesize current literature on individuals with coexisting diabetes and SUD, focusing on current treatments.

A systematic search of the PubMed and Embase databases was conducted using Medical Subject Headings and keyword strategies. After removing duplicates, studies were screened based on predefined inclusion and exclusion criteria, including relevance to the topic, publication within the past 10 years, availability of full-text articles, English language, and sufficient scope.

From an initial pool of 1,135 articles, 1,126 were excluded for not meeting eligibility, leaving nine retrospective studies for inclusion. Treatment strategies identified for individuals with coexisting diabetes and SUD encompassed pharmacotherapies (semaglutide and buprenorphine-naloxone), diligent adherence to SUD treatment, care management programs targeting individuals with multimorbidity, and reinforcers or rewards to either treatment adherence or drug abstinence. Although these approaches showed improvement in health outcomes, they primarily addressed diabetes and SUD separately. Additionally, few studies incorporated behavioral therapies, such as mindfulness-based interventions, despite their potential relevance to this population.

This review highlights the current treatment approaches for individuals with coexisting diabetes and SUD. The findings underscore the need for integrated care models that simultaneously address both conditions. Incorporating behavioral interventions alongside standard care strategies may offer a more comprehensive and effective treatment framework for this underserved population.