A new study has discovered a link between insulin resistance and schizophrenia, suggesting that greater vigilance is needed by clinicians in monitoring schizophrenia patients with comorbidities.
Scientists at the Coventry and Warwickshire Partnership NHS Trust found that markers of prediabetes were associated with first-episode psychosis, which could be described as “developing schizophrenia”, and that links between the two conditions could be inflammatory in nature.
Senior author Dr Benjamin Ian Perry and colleagues identified 12 studies that included biochemical assessment of patients with first-episode psychosis and prediabetes.
Blood glucose levels and insulin resistance were measured among the participants: blood glucose levels were not significantly linked with first-episode psychosis, but insulin resistance was higher in these patients than control patients. Additionally, patients with first-episode psychosis had increased impaired glucose tolerance.
“Our results suggest that there might be an intrinsic link between abnormal glycemic control and psychosis, beneath the effects of diet, medication, and reduced access to healthcare that are all known causes for those with schizophrenia to suffer from diabetes,” Perry told Medscape Medical News.
“[The findings] support the hypothesis that schizophrenia and diabetes share intrinsic disease links, which might be inflammatory in nature.
“If patients are at an increased risk of developing glycemic regulation abnormalities even before the administration of antipsychotics, heightened vigilance and stricter control of the metabolic indices of patients with schizophrenia is essential to help reduce the physical health burden associated with the disease.”
The investigators noted that patients with schizophrenia are around 30 per cent more likely to have type 2 diabetes than the general population, but differences in body fat did not explain the findings of this study, which was published online in the Lancet Psychiatry.
In an accompanying editorial, Dr Mehrul Hasnain of Eastern Health, Waterford Hospital, St John’s, Newfoundland, Canada, who wasn’t involved in the study, said: “We need to start entertaining the idea that there is more to the metabolic vulnerability of patients with schizophrenia (and possibly bipolar disorder) than can be attributed to unhealthy lifestyle and drug adverse effects.”

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