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Cardiovascular and metabolic risk
Diabetes and glucose disturbances in patients with psychosis in Sweden
  1. Eric Olsson1,2,
  2. Jeanette Westman3,
  3. Dzana Sudic Hukic2,4,
  4. Sven V Eriksson5,
  5. Gunnar Edman3,4,6,
  6. Robert Bodén7,8,
  7. Erik Jedenius1,
  8. Johan Reutfors7,
  9. Anders Berntsson2,
  10. Agneta Hilding9,
  11. Martin Schalling4,9,
  12. Claes-Göran Östenson9,
  13. Urban Ösby3,4,6
  1. 1Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  2. 2Department of Adult Psychiatry, PRIMA Barn och Vuxenpsykiatri AB, Stockholm, Sweden
  3. 3Department of Neurobiology, Care Sciences and Society, Centre of Family Medicine, Karolinska Institutet, Stockholm, Sweden
  4. 4Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
  5. 5Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
  6. 6Department of Psychiatry, Tiohundra AB, Norrtälje, Sweden
  7. 7Department of Medicine Solna, Centre for Pharmacoepidemiology, Karolinska Institutet, Stockholm, Sweden
  8. 8Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden
  9. 9Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Dr Eric Olsson; eric.olsson{at}primavuxen.se

Abstract

Objective The objectives of this study were to (1) analyze the prevalence of diabetes, prediabetes, and antidiabetic medication in patients with psychosis compared with control subjects and (2) determine what factors in patients with psychosis were associated with antidiabetic medication.

Method We studied 977 patients with psychosis recruited from outpatient clinics in Stockholm County, Sweden, and they were compared with 3908 non-psychotic control subjects for fasting plasma glucose levels; prevalence of diabetes, prediabetes, antidiabetic treatment, and tobacco use; and blood pressure, weight, height, and waist circumference. Group differences were evaluated with analysis of variance and χ2 test, and factors associated with antidiabetic treatment were evaluated with logistic regression.

Results Diabetes was observed in 94 (10%) patients with psychosis, 2.7 times the prevalence observed in control subjects. Among patients with psychosis, 87 (10%) had prediabetes (fasting glucose, 6.1–6.9 mmol/L) compared with 149 (3.8%) control subjects. Most patients with psychosis (77%) who had prediabetes fulfilled criteria for metabolic syndrome. In patients with psychosis, both lipid-lowering medication and fasting glucose were significantly associated with antidiabetic treatment. There was no significant relation between antidiabetic treatment and lifestyle factors such as smoking or degree of psychiatric illness.

Conclusions The high prevalence of impaired fasting glucose and metabolic syndrome in patients with psychosis warrants further clinical research in preventing or delaying the onset of diabetes in these patients by pharmacotherapy and/or lifestyle intervention.

  • Schizophrenia
  • Metabolic Syndrome

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjdrc-2015-000120

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