Risk of suicidal ideation and self-inflicted injury in patients living with diabetes mellitus

Abstract

Objective: To document risk of suicidal ideation and self-inflicted injury using the Suicidal Behaviors Questionnaire-Revised (SBQ-R) in diabetic patients.

Methodology: This observational study was conducted at Department of Medicine and Allied, Chaudhary Muhammad Akram Teaching and Research Hospital Lahore Pakistan, from December 2025 to April 2026. Diabetes mellitus was diagnosed according to American Diabetes Association criteria. SBQ-R score ≥ 7 was indicative of high suicide risk. Using non-probability consecutive sampling, 200 diabetic patients, diagnosed for at least 6 months, of either gender, aged ≥ 18 years, were included. Patients with pre-existing psychiatric illnesses, cognitive impairment and acute medical emergencies were excluded. Demographic and clinical information was obtained, after which SBQ-R was administered. Data were analyzed using SPSS, version 23.

Results: Mean SBQ-R score was 5.5 ± 2.9 with 44 (22.0%) at risk of suicide ideation and self-inflicted injury. Chi-square stratification revealed statistically significant association of younger age with suicide risk (p-value 0.045). In terms of treatment regime, participants under ‘lifestyle modifications’ had the greatest suicide risk (80.0%), followed ‘injectable insulin only’ (30.3%), p-value 0.003. Multivariable binary logistic regression analysis revealed patients with longer diabetes duration and peripheral neuropathy had approximately 2.6 (p-value 0.041) and 3.3 (p-value 0.027) times higher odds of suicide risk, respectively. Treatment regime showed a statistically significant overall association with suicide risk (p-value 0.023).

Conclusion: Suicide risk was seen in almost a quarter of diabetics, being associated with younger age, longer diabetes duration and peripheral neuropathy, highlighting the importance of incorporating mental health assessment into routine management.