Prevalence and Correlates of Diabetes in National Schizophrenia Samples

Abstract

People with schizophrenia may be at increased risk for Type II diabetes because of the side effects of antipsychotic medication, poorer overall physical health, less healthy lifestyles, and poorer health care. The present study uses data bases collected by the Schizophrenia Patient Outcomes Research Team (PORT) to assess the prevalence and demographic and clinical correlates of diabetes within large populations of persons receiving treatment for schizophrenia. In the Schizophrenia PORT, Medicaid and Medicare data from 1991 and more recent interview data were collected regarding the comorbidity of schizophrenia and diabetes: prevalence, quality of life, physical health, and services utilization and costs. The study found that rates of diagnosed diabetes exceeded general population statistics well before the widespread use of the new antipsychotic drugs. Risk factors for diabetes were similar to those observed in the general population. The linkage of diabetes to poor physical health, medical morbidity, and increased service use and cost requires attention. This study of diabetes in the early 1990s suggests that even before the widespread use of the atypical antipsychotic drugs, diabetes was a major problem for persons with schizophrenia.

Effects of Olanzapine and Ziprasidone on Glucose Tolerance in Healthy Volunteers

“…These data indicate a significant decrease in whole body insulin sensitivity after oral intake of olanzapine, 10 mg/day for 10 days, after 80 min (po0.015), 100 min (po0.001), and 120 min (po0.0001) of glucose clamp. Effects of olanzapine and ziprasidone J Sacher et al population but is not associated with the risk of DM2 during antipsychotic treatment does not seem very likely given the evidence for a higher rather than a lower prevalence of DM2 in patients suffering from a major mental disorder in almost all data sets published to date (Mukherjee et al, 1996;Dixon et al, 2000;Okamura et al, 2000;Mokdad et al, 2001;Haupt and Newcomer, 2002;Newcomer et al, 2002;Ryan et al, 2003;Newcomer, 2004;Haupt et al, 2007). A second metabolic effect is depicted in Figure 2 and Table 2.…”

“…Studying these effects in healthy volunteers minimizes the effects of lifestyle that may account for some of the impairments in glucose metabolism seen in schizophrenia patients (Mukherjee et al, 1996;Dixon et al, 2000;Ryan et al, 2003).…”

Diabetes and Cardiovascular Care Among People with Severe Mental Illness: A Literature Review

“…In the Schizophrenia Patient outcomes Research Team (PORT) field study of people with schizophrenia from 1994 to 1996, the age-adjusted prevalence of self-reported diabetes was close to 15 %, almost twice as high as the U.S. population (9.3 %). 27,28 Since that time, other reports suggest even higher rates, with the prevalence of diabetes in people with SMI typically being twofold to threefold higher than age-matched samples from the general population. 10,[29][30][31][32][33][34][35] We are aware of only two large studies examining pre-diabetes among people with schizophrenia.…”

“…36 Another study of Medicare enrollees with schizophrenia (N = 14,182) found that African Americans with schizophrenia had significantly higher rates of diabetes than Caucasians (15.5 % vs. 11.7 %, p < 0.001), even before the wide-spread use of SGA medications. 27 Small studies found a higher prevalence of the metabolic syndrome among Hispanics with SMI taking antipsychotics, ranging from 35 % to 74 %. 86,87 However, other studies have yielded conflicting results--with no statistically significant differences between racial/ ethnic groups.…”

“…In the Schizophrenia PORT field study (N = 719), Medicaid sample (N = 6066) and Medicare sample (N = 14,182), all found that women with schizophrenia had higher rates of diabetes than men (field study: 21.9 % vs 10.8 %, p < 0.001; Medicaid: 15 % vs. 4.3 %, p < 0.001; Medicare: 16.7 % vs. 8.8 %, p < 0.001). 27 In the CATIE trial, women with schizophrenia were found to have significantly higher rates of the metabolic syndrome than men [51.6 % vs. 36.0 %, p < 0.0002]. 15 This finding is different than the general population, where the prevalence of diabetes is greater among men than women.…”