Glucose Tolerance in Chronic Schizophrenia and Senile States

Abstract

ABNORMAL glucose tolerance, characterized by a reduction of the tolerance to ingested sugar, has been reported in various mental disorders by a number of investigators. Diabetic-like blood sugar curves of a sustained type have been found in cases of schizophrenia, indicating a biochemical disturbance of the carbohydrate metabolism in this condition. Meduna and Vaichulis 1 reported diabetic-like reaction to the Exton-Rose glucose tolerance test in about 60 per cent of unselected schizophrenic patients. In a previous study, Meduna, Gerty and Urse 2 demonstrated a delay in the return of the blood sugar to a normal level following infusion of a dextrose solution in all of their 20 untreated schizophrenic patients. They concluded that a disturbance of the carbohydrate metabolism existed, as indicated by a delayed utilization of blood sugar, and postulated that this disturbance might be one of the etiologic factors in schizophrenia. However, Meduna, Braceland and Vaichulis 3 reported that the same type of abnormal curve can be obtained in the depressed and manic phases of manic-depressive psychosis and theorized that the same pathologic disturbance could be of etiologic significance in both schizophrenia and manicdepressive psychosis. Freeman, Rodnick, Shakow and Lebeaux * studied the carbo¬ hydrate tolerance of mentally disturbed soldiers and reported a reduction in glucose tolerance in two thirds, the dysfunction occurring not only in patients with schizo¬ phrenia but also in patients with nonpsychotic mental disturbances. They presented the hypothesis that reduced glucose tolerance is somehow related to emotional ten-

Some Clinical and Biochemical Variables in Patients with Chronic Brain Syndrome

“…No special clinical significance can be ascribed to the difference in blood sugar levels between the normal and the psychotic groups (Table 2). This is evident from reports in the literature of higher values (87 ± 8 mg per 100 ml) for normal elderly men (10) than those reported by Libow (3), and of lower values (85 ± 9 mg per 100 ml) for senile psychotic men (11) than those reported by us (Table 2). Moreover, comparisons were not made of the PC glucose levels in our study with those reported by other laboratories because of the marked effect of diet on the blood sugar level (12).…”

“…Furthermore, reduced sugar tolerance has also been reported to occur in the depressive and manic phases of manic‐depressive psychosis (14), in schizophrenia (15) and in any situation involving psychologic stress (16). Of special interest in the present study was the finding that sugar metabolism as determined by the Exton‐Rose sugar tolerance test was more disturbed and labile in patients with SD than in patients of comparable age with chronic schizophrenia (11). The duration of hospital stay did not account for the difference in the two groups, as both had been in institutions for long periods.…”

Age Differences in the Intravenous Glucose Tolerance Tests and the Response to Insulin

“…In a number of investigations, reduction in glucose tolerance, i.e., a slower rate of return to fasting levels of blood sugar following the oral (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17) or intravenous (18)(19)(20) administration of glucose, has been reported in older people. The diminished glucose tolerance in the older individual might be due to: (a) inadequate release of insulin from the pancreas, or greater inactivation of endogenously released insulin, (b) the loss of functioning protoplasm with increasing age so that less metabolizing tissue is removing glucose from the blood, (c) a diminution in the effectiveness of the metabolic processes involved in the removal of sugar from the blood stream, (d) alterations in the rate of release of glucose from the liver, or (e) a reduction in the volume in which the glucose is originally distributed in the aged.…”

Hyperglycemia with antipsychotic treatment

“…Several studies have found increasing rates of diabetes or hyperglycemia in patients with schizophrenia or in association with antipsychotic treatment. An increased prevalence of diabetes was observed in schizophrenic patients predating the introduction of antipsychotic drugs [3][4][5]. In one study of 95 patients with schizophrenia, the overall prevalence of diabetes was 15.8% [6].…”