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Professional Issues >> Total Wellness
Diabetes in Schizophrenia and Bipolar Disorder
Recent studies have reported treatment-emergent diabetes with some atypical antipsychotics. In fact, since the advent of the older antipsychotics in the 1950s, antipsychotic drugs have been linked to diabetes. However, since the early 1900s, glucose intolerance, hyperglycemia, and diabetes mellitus have been reported in patients with schizophrenia-related disorders.35,36
Mukherjee et al.35 examined the prevalence of diabetes mellitus type II in 95 patients with schizophrenia in Italy. An overall prevalence of 16% was found, much higher than the rate (3%) of diabetes found in the general population of Italy. Diabetes was more common in patients not receiving neuroleptics than in those who were, Cassidy et al.36 examined 3445 inpatients with bipolar disorder for a comorbid diagnosis of diabetes mellitus. About 10% of these patients had diabetes mellitus, a figure much higher than that estimated for the general population of the U.S. (3%).
Although psychotropic medications have been linked to diabetes, the presence of diabetes could be related to other comorbidities, hepatitis C, substance abuse, or familial history, not the treatment agent. Studies show the incidence of hyperglycemia with olanzapine is infrequent, occurring in between 1/100 and 1/1000 patients, a rate comparable with that of placebo.20 Patients with schizophrenia should be tested at baseline for the presence of diabetes and related disorders.
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