Interventions for preventing type 2 diabetes in adults with mental disorders in low- and middle-income countries

Mishu, Masuma Pervin; Uphoff, Eleonora; Aslam, Faiza; Philip, Sharad; Wright, Judy; Tirbhowan, Nilesh; Ajjan, Ramzi; Azdi, Zunayed Al; Stubbs, Brendon; Churchill, Rachel; Siddiqi, Najma

doi:10.1002/14651858.cd013281.pub2

Cited by 7 publications

(9 citation statements)

References 159 publications

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“…[1][2][3][4][5] This raises an obvious question regarding potential prevention of DM in this at-risk group of patients. While there has been very little evidence supporting specific pharmacological and non-pharmacological interventions to reduce obesity and the risk of DM in the context of bipolar disorder, 48,49 a recent study among patients with bipolar disorder and insulin resistance suggests that metformin may be beneficial in this regard. 38 Specifically, in the randomized controlled trial by Calkin and colleagues, 14 weeks of daily treatment with 2 mg metformin led to 11 of 20 participants no longer meeting criteria for insulin resistance, compared with only 1 of 25 participants receiving placebo.…”

Section: Cumulative Dose-response-like Associationsmentioning

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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Section: Cumulative Dose-response-like Associationsmentioning

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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“…However, the usefulness of educational programs such as STEPWISE, a theory-based group education in the field of health-promoting lifestyle, which at 12 months demonstrated neither clinical nor financial benefits for patients with schizophrenia [49], is questioned. Despite the presence of controversy related to the difference in the risk of developing carbohydrate metabolism disorders between patients using typical and atypical antipsychotics [50], it should be borne in mind that sertinodl, zotepine, clozapine, and olanzapine are associated with a high risk of weight gain, while amisulpiride, asenapine, quetiapine, risperidone, paliperidone, and iloperidone -with moderate, and aripirazole, brexiprazole, cariprazole, and ziprasidone --with low risk. Therefore, taking into account also the aforementioned diabetogenic potential, a switch to another antipsychotic medication is suggested, if possible [51].…”

Section: Reviewmentioning

confidence: 99%

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

et al. 2022

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This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commerciallyThe Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 reported that mental disorders accounted for 654.8 million estimated cases in 1990 and 970.1 million cases in 2019 (an increase of 48.1%) [5]. A review and meta-analysis perform by Jongsma et al. showed that the prevalence of all psychotic disorders was 26.6 per 100,000 person-years [6]. It is estimated that DM can affect 8.7% with major depressive disorders, 6.2% with bipolar disorders, and 12% of patients with severe mental illnesses (schizophrenia, depression, bipolar and psychotic disorders). A high (19%) incidence of "prediabetic conditions" in patients with various types of psychoses has also been observed [7]. A recent study by Liu et al. indicates that patients with bipolar disorders have nearly 1.6 times greater risk of developing DM [8]. These data may be underestimate to the real risk of antipsychotic drugs. This is because they often do not take into account the presence of undiagnosed type 2 diabetes before using antipsychotic drugs.

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“…The latest published reviews assessing different metabolic aspects have mixed results. A recent Cochrane review evaluating interventions to prevent type 2 diabetes in patients with SMD in low- and middle-income countries was inconclusive [ 14 ]. A meta-analysis by Naslund et al of lifestyle weight loss interventions for overweight and obesity in SMD patients, concluded that such interventions were effective, especially those lasting longer than 12 months, which have a clinically significant ≥ 5% weight loss at follow-up [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Metabolic impact of a nutrition education program for the promotion of fruit and vegetable consumption with people with severe mental disorders (DIETMENT)

et al. 2022

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Objectives The aim of this study is to determine the metabolic impact of a nutrition education program on metabolic parameters and the presence of metabolic syndrome (MetS). Results Seventy-four patients were included (mean age, 48.7 years [Standard deviation, SD: 10.8], 55.4% men). The diagnoses of SMD were 37.8% schizophrenia and related disorders; 29.7% bipolar disorder; 25.7% depressive disorder; 4.1% personality disorders; and 2.7% obsessive compulsive disorders. Thirty-seven individuals were distributed in both the intervention group (IG) and the control group (CG). In the IG the presence of MetS was 56.3% and in the CG 46.7%, with no statistically significant difference (p = 0.309). At the end of the study, glomerular filtrate decreased in the IG, body mass index and abdominal perimeter increased in both groups, and there were no changes in metabolic parameters between the groups. Between the baseline and the end of the study, there was no increase in the number of patients diagnosed with MetS (14 at both points); and in the CG the increase was from 8 to 12 (p = 0.005). An intervention based on fruit and vegetable intake could prevent progression to MetS in individuals with SMD, decreasing the likelihood of cardiovascular disease. Trial registration The trial was retrospectively registered on International Standard Randomised Controlled Trial Number (ISRCTN) Register on 11 March 2022 (ISRCTN12024347)

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Interventions for preventing type 2 diabetes in adults with mental disorders in low- and middle-income countries

Abstract: This is a repository copy of Interventions for preventing type 2 diabetes in adults with mental disorders in low and middle income countries.

Cited by 7 publications

References 159 publications

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

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

Diagnosis and management of hyperglycaemia in patients treated with antipsychotic drugs

Metabolic impact of a nutrition education program for the promotion of fruit and vegetable consumption with people with severe mental disorders (DIETMENT)

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