News

Researchers call for rethink on relationship between schizophrenia and type 2 diabetes

by Barbara Hewitt on January 19, 2017

Health professionals need to rethink the link between type 2 diabetes and schizophrenia so that those with early signs of the mental health condition can get the right treatment, new research suggests.

Researchers have found that people with early schizophrenia are at an increased risk of developing type 2 diabetes, even when the effects of drugs, diet and exercise are taken out of the equation.

woman-depressionSchizophrenia is known to be associated with a reduced life expectancy of up to 30 years. This is largely due to physical health disorders such as heart attack or stroke, for which type 2 diabetes is a major risk factor.

People with long term schizophrenia are three times more likely than the general population to have diabetes, something which has previously been attributed to poor diet and exercise habits in this group, as well as the use of antipsychotic medication.

However, a new study from researchers at King’s College London has examined whether diabetes risk is already present in people at the onset of schizophrenia, before antipsychotics have been prescribed and before a prolonged period of illness that may be associated with poor lifestyle habits such as poor diet and sedentary behaviour.

The researchers highlighted several factors that could increase the likelihood of developing both conditions, including shared genetic risk and evidence of shared developmental risk factors, such as premature birth and low birth weight.

They examined pooled data from 16 studies comprising 731 patients with a first episode of schizophrenia and 614 people from the general population. They analysed blood tests from these studies and found that patients with schizophrenia showed higher risk of developing type 2 diabetes compared with healthy controls.

Specifically, the patients had higher levels of fasting blood glucose, which is a clinical indicator of diabetes risk. The higher the glucose in your blood, the more likely you are to have diabetes as the body cannot efficiently remove glucose into cells where it can be used as fuel.

They also discovered that compared with healthy controls, patients with first episode schizophrenia had higher levels of insulin and increased levels of insulin resistance, again supporting the notion that this group are at higher risk of developing diabetes.

These results remained significant even when analyses were restricted to studies where patients and controls were matched for dietary intake, the amount of regular exercise they engaged in, and ethnic background.

This suggests that the results were not wholly driven by differences in lifestyle factors or ethnicity between the two groups, and may therefore point towards schizophrenia’s direct role in increasing risk of diabetes.

‘Our findings tell us that people with early schizophrenia have already started down the road to developing diabetes, even if they haven’t been diagnosed with diabetes yet,’ said Dr Toby Pillinger, first author of the study from the Institute of Psychiatry, Psychology and Neuroscience (IoPPN) at King’s College London.

‘Our results also suggest that patients should be given better education regarding diet and physical exercise, monitoring, and, where appropriate, early lifestyle changes and treatments to combat the risk of diabetes,’ he added.

Professor Oliver Howes, senior author of the study from the IoPPN, also called for a rethink. ‘These findings are a wake-up call that we need to rethink the link between diabetes and schizophrenia and start prevention right from the onset of schizophrenia. It is a case of thinking mind and body right from the start,’ he said.

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The opinions expressed in this article do not necessarily reflect the views of the DiabetesForum.com Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.