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Impaired glucose homeostasis at time of schizophrenia diagnosis

In this study, psychiatric investigators sought to discover if people presenting with a first episode of schizophrenia had an inherent risk for glucose dysregulation before the illness became a chronic disease, and they had received long-term treatment. They performed a meta-analysis examining whether individuals with first-episode schizophrenia already exhibit alterations in glucose homeostasis compared with controls. They found that glucose homeostasis is altered from illness onset in schizophrenia, indicating that people are at increased risk of diabetes as a result of the underlying illness.

By Colin Kenny, GP, Dromore

The incidence of type 2 diabetes may be 2-3 times higher in people living with schizophrenia than in the general population. Psychiatric medication may play some part in this. Here, the investigators carried out a meta-analysis of 14 case–control studies comprising 1345 participants. They sought individuals with first-episode schizophrenia who had elevated fasting plasma glucose levels, elevated plasma glucose levels after an oral glucose tolerance test, and elevated fasting plasma insulin levels, as well as greater insulin resistance compared with healthy individuals serving as controls.

They found that people presenting with schizophrenia often had several markers of glucose dysregulation including raised fasting plasma glucose levels, reduced glucose tolerance and increased insulin resistance at illness onset. These findings show that glucose homeostasis is altered from illness onset in schizophrenia, indicating that individuals are at increased risk of diabetes as a result. These findings have implications for monitoring and treatment choices for people with schizophrenia.

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