Diabetes Mellttus in Patients on Lithium

Craig, James W.; Abu-Saleh, M.; Smith, Bridget; Evans, Idwal

doi:10.1016/s0140-6736(77)92923-3

Cited by 21 publications

(5 citation statements)

References 4 publications

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“…On the subject of lithium, Johnston (1977) and Craig et al (1977) warned that lithium sometimes seemed to precipitate the onset of maturity onset DM and Shopsin et a! (1972) found diminished glucose tolerance after its acute administration.…”

Section: Diabetes Mellitus and Psychiatric Disordermentioning

confidence: 99%

Psychiatric Aspects of Diabetes Mellitus

Wilkinson

1981

Br J Psychiatry

132

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Section: Diabetes Mellitus and Psychiatric Disordermentioning

confidence: 99%

Psychiatric Aspects of Diabetes Mellitus

Wilkinson

1981

Br J Psychiatry

132

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“…4,[13][14][15][16] While the increased risk of DM with antipsychotics is rather well established, it is less clear how lithium-a widely used mood stabilizer in the treatment of bipolar disorder 12,17 -affects the risk of DM. While there were initial concerns of increased risk of DM with lithium treatment, 18,19 studies have generally suggested either no effect 14,18 or even a protective effect of lithium on the risk of DM. 16,20 With regard to the latter, it has been proposed that lithium reduces the risk of DM via inhibition of glycogen synthase kinase-3 (GSK-3), 21 which lowers glycogen synthase activity 22,23 and reduces pancreas islet inflammation.…”

Section: Introductionmentioning

confidence: 99%

Pharmacological treatment of bipolar disorder and risk of diabetes mellitus: A nationwide study of 30,451 patients

et al. 2023

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Objective While treatment with antipsychotics and antiepileptics have been associated with an increased risk of diabetes mellitus (DM), lithium may have the opposite effect via inhibition of glycogen synthase kinase‐3. The aim of this study was to investigate whether treatment of bipolar disorder with lithium, antipsychotics, or antiepileptics is associated with the risk of DM in a real‐world clinical setting. Methods Using nationwide registers, we identified all patients diagnosed with bipolar disorder in Danish Psychiatric Services from January 1, 1996, to January 1, 2019 (N = 30,451). The risk of developing DM was operationalized via hospital diagnoses and redeemed prescriptions for glucose‐lowering drugs. For lithium, antipsychotics, valproate, and lamotrigine, we calculated hazard rate ratios (HRR) for developing DM via adjusted Cox proportional hazards models. Potential cumulative dose–response‐like associations were examined using the log‐rank test. Results During follow‐up (245,181 person‐years), 2107 (6.9%) patients developed DM. Compared with non‐users of the respective drugs, we found no clinically or statistically significant difference in the risk of developing DM among patients receiving lithium (n = 11,690; incidence rate of DM/1000 person‐years (IR) = 8.87, 95% CI: 8.02–9.90; HRR = 0.94, 95% CI: 0.84–1.06) or lamotrigine (n = 11,785; IR = 7.58, 95% CI: 6.69–8.59; HRR = 0.89, 95% CI: 0.77–1.02), respectively. Conversely, for patients receiving valproate (n = 5171; IR = 12.68, 95% CI: 10.87–14.80; HRR = 1.34, 95% CI: 1.14–1.58) and antipsychotics (n = 22,719; IR = 12.00, 95% CI: 11.14–12.94; HRR = 1.65, 95% CI: 1.45–1.88), respectively, there was increased risk of developing DM. For antipsychotics, we observed a clear cumulative dose–response‐like association with the risk of DM. Conclusions Treatment with valproate and antipsychotics—but not with lithium and lamotrigine—was associated with increased risk of DM in a real‐world cohort of patients with bipolar disorder.

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“…There is evi dence that lithium treatment may affect glucose toler ance [reviews in 2,3], and a number of instances have been reported where diabetes developed during lithium treatment [4][5][6][7][8][9][10], The case reports did not permit dis tinction between coincidence and lithium induction.…”

Section: Introductionmentioning

confidence: 99%

Does Long-Term Lithium Treatment Induce Diabetes mellitus?

Vestergaard¹,

Schou

1987

Neuropsychobiology

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Fasting blood sugar was determined in manic-depressive patients before the start of lithium treatment and at intervals during treatment for up to 6 years. The total exposure time to lithium was 495.5 years. Even though the patients gained significantly in age and body weight during the treatment, their mean blood sugar values remained the same as before treatment was started, and only 1 patient developed manifest diabetes. There is no reason to believe that long-term lithium treatment leads to increased risk of developing diabetes mellitus.

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Diabetes Mellttus in Patients on Lithium

Cited by 21 publications

References 4 publications

Psychiatric Aspects of Diabetes Mellitus

Psychiatric Aspects of Diabetes Mellitus

Pharmacological treatment of bipolar disorder and risk of diabetes mellitus: A nationwide study of 30,451 patients

Does Long-Term Lithium Treatment Induce Diabetes mellitus?

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