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The prevalence of diabetes is significantly higher in patients with schizophrenia or schizoaffective disorder relative to the general population — irrespective of the use of, or type of, antipsychotic medication. In the April issue of Diabetes Care, investigators report that oral glucose tolerance tests in 200 mainly Caucasian adults with schizophrenia or schizoaffective disorder showed that 14 (7%) had hyperglycemia — 3 had impaired fasting glucose and 11 had impaired glucose tolerance. Moreover, 29 (14.5%) were diabetic, of whom 13 were newly diagnosed with the disease.
"Compared with a 1.5% prevalence of diabetes in the age-matched general Dutch population, the prevalence of identified cases was significantly increased in the study population," Dr. Dan Cohen from University Medical Center Utrecht, the Netherlands and colleagues note in their report.
Dr. Cohen stated that, "The increased prevalence begins early, certainly after 30 and possible even earlier." "This suggests that an early aging effect is present in the population of patients with schizophrenia or schizoaffective disorder," he and his colleagues note in their report.
As mentioned, insulin resistance was higher in the study population as a whole regardless of the use of antipsychotic medication and, if used, irrespective of its type (typical or atypical). No evidence of beta-cell defects was found.
These findings, Dr. Cohen and colleagues say, support a body of literature linking disturbances in glucose metabolism to schizophrenia and support "measurement of fasting glucose in all patients with schizophrenia, irrespective of prescribed antipsychotic drug."
"Monitoring of glycemic control is indicated above the age of 30 and advised under 30 years in all patients with antipsychotic medication, both typical and atypical," Dr. Cohen added. Diabetes Care 2006;29:786-791.
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