With many conditions, there are other medical issues that present at the same time. Someone with one kind of illness, might be at a higher risk for other diseases because of medications, lifestyle limitations or other factors. New research from the United Kingdom shows that patients who suffer from schizophrenia are at an increased risk of developing Type 2 diabetes. While it was previously believed that the development of diabetes and cardiovascular issues in these patients was due to a sedentary lifestyle, poor diet and possibly anti-psychotic medications, a recently published analysis from a team at King’s College in London that took these factors out of the equation, suggested an increased risk for diabetes in schizophrenic patients, aside from medication, diet and exercise.
The new information, which was published this month in JAMA Psychiatry, investigated the possibility that the increased diabetes risk in schizophrenics is present before the onset of the first psychotic episode and before anti-psychotic medication is given. Normally, once a patient has had their first episode and goes on medication (which is often changed frequently due to trial and error of getting just the right dose and drug) a long period of illness follows when the patient is not very physically active and might have a poor diet as well.
The study was an analysis of sixteen research projects already conducted. The team at King’s College pooled all of the data from these studies to see if a clear correlation could be extrapolated from the collected information. These studies involved a total of 731 patients after their first episode of schizophrenia and a control group of 614 people from the general population who had never been mentally ill. They looked specifically at blood work from these study participants and found that in comparison to healthy individuals, those patients who had suffered their first episode of schizophrenia showed an increased risk of developing Type 2 diabetes.
This was determined by looking at level of fasting blood sugar. The standard for judging one’s risk for developing diabetes is the level of glucose in the blood during a fast. The higher it is, the more risk that patient has, because the glucose remains in the blood instead of being moved into cells as it normally should be. Insulin levels were also considered in the study, showing that first episode schizophrenics had higher levels of insulin and insulin resistance, also risk factors for developing full-blown diabetes. Even when factors of diet, exercise and ethnic background were considered and removed from the data, the increased risk remained.
Dr. Toby Pillinger from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King's College London and lead author of the research, explained, "The mortality gap between people with schizophrenia and the general population is growing, and there is a need for novel approaches to halt this trend. Our study highlights the importance of considering physical health at the onset of schizophrenia, and calls for a more holistic approach to its management, combining physical and mental healthcare.” He also explained that since many anti-psychotic medications raise the risk of diabetes, health care providers must understand that these patients may already be on the way to developing the disease and take this into consideration when prescribing medication. The results also show that more needs to be done for these patients in terms of education and support for diet, exercise and stress reduction, all of which aggravate schizophrenia symptoms and increase diabetes risk, as well as the risk for other cardiovascular illnesses. The video below explains more about the findings and what physicians who treat patients with schizophrenia need to know.
Sources: King’s College, UPI, PsychCentral, JAMA Psychiatry