The metabolic syndrome often develops into and is usually present in type 2 diabetes in association with premature cardiovascular disease. Treating diabetes can prevent some of its devastating consequences, but it does not eliminate them all. With the goal to eliminate all the adverse consequences of the syndrome, the optimal approach would be through its prevention. Insulin resistance appears to be pivotal to development of the syndrome complex that includes features such as intra-abdominal or visceral obesity, hypertension, impaired glucose homeostasis, dyslipidemia with elevated triglycerides and low high-density lipoprotein without elevations of low-density lipoprotein, a procoagulant state, and impaired vascular function. Improving the insulin resistance needs to be the primary target of the therapy. Hyperglycemia, which is one feature of the metabolic syndrome, may range from impaired glucose tolerance (IGT) to overt diabetes. The risk of progression of the disease from IGT to diabetes is increased with time and the presence of various risk factors. Diabetes is a disease of serious concern because of the associated complication of the disease and the huge impact on the health care costs. Many short- and longer-term trials have shown promise in the prevention of diabetes and its metabolic and cardiovascular consequences.
Diabetes and mental disorders are common chronic illnesses in the United States. Recently, the introduction of a new class of atypical antipsychotic medications has been a major treatment advance for patients with mental disorders. Because of increased use of atypical antipsychotic medications, new and unanticipated side effects have often appeared. Treatment-emergent diabetes has been described for conventional and atypical antipsychotics. People with schizophrenia may be at increased risk for type 2 diabetes because of the side effects of antipsychotic medication, underlying predisposition, and less healthy lifestyles.
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