Schizophrenia could increase risk of diabetes

People with early schizophrenia are at an elevated risk of diabetes, even if the effects of medications, exercise and diet are taken based on an investigation by researchers from King’s College London.

Schizophrenia is proven to be associated with a reduced life expectancy of around 30 decades. This is largely due to bodily health disorders such as heart attack or stroke, for which type two diabetes is a significant risk element.

People with schizophrenia are three times more likely than the general population to have diabetes, something that has been attributed to diet and exercise habits within this group, in addition to the use of antipsychotic medication.

Published in JAMA Psychiatry, this fresh study examined whether diabetes risk is currently present in people at the start of schizophrenia, before antipsychotics have been prescribed and before a prolonged period of illness that could be related to poor lifestyle habits (such as poor diet and sedentary behaviour).

The researchers pooled data from 16 studies comprising 731 patients and 614 people from the general populace. Blood tests were analysed by them from these research and found that patients with schizophrenia showed greater chance of developing type 2 diabetes compared with controls.

The patients had greater levels of blood sugar, which can be a clinical sign of diabetes risk. The greater the sugar in your bloodstream, the more likely you are to have diabetes since the body cannot efficiently remove glucose into cells where it can be utilized as fuel.

They discovered that in comparison with controls, patients with first episode schizophrenia had elevated amounts of insulin resistance and higher levels of insulin, again supporting the idea that this group are at greater risk of developing diabetes.

These results remained significant when investigations were limited to the total amount of exercise they engaged in research where patients and controls were matched for intake, and background. This suggests that differences in lifestyle factors or ethnicity between the two groups not wholly drove the results, and may point towards the direct role of schizophrenia in increasing risk of diabetes.

Elements that could increase the likelihood of developing both conditions are highlighted by the researchers, including signs of shared risk factors, such as birth and low birth-weight and shared genetic risk. It’s also thought that the anxiety related to growing schizophrenia, which sees amounts of the stress hormone cortisol rise, may also give rise to a greater risk of diabetes.

Dr Toby Pillinger, first author of the research by the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) at King’s College London, said: ‘The mortality gap between people with schizophrenia and the general populace is growing, and there’s a need for novel methods to halt this trend. Our research calls combining physical and mental healthcare, also highlights the importance of considering health at the start of schizophrenia.

‘Our findings tell us that people with early schizophrenia have already started down the path to developing diabetes, even if they haven’t been diagnosed with diabetes.’

Dr Pillinger included: ‘Given that the chance of diabetes might increase further, clinicians have a duty to pick an antipsychotic at an proper dose. Our results also suggest that patients must be given improved education regarding diet and exercise and, where appropriate, premature lifestyle changes and remedies to fight the risk of diabetes.’

Senior author of the study by the IoPPN at King’s College London, Professor Oliver Howes, said: ‘These findings are a wake-up forecast that we need to rethink the connection between schizophrenia and diabetes and start prevention directly. It’s a case of thinking mind and body right from the beginning.’

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