Patients with diabetes and comorbid schizophrenia have an increased risk for hyperglycemic episodes compared with patients with diabetes who do not have schizophrenia, according to results published in Diabetes & Metabolism. However, the results also indicated that patients with diabetes and schizophrenia who had a longer duration of antipsychotic medication use had fewer hyperglycemic episodes.
The study included participants with diabetes and schizophrenia (n = 13,858) and controls with diabetes and no schizophrenia (n = 55,407) matched by gender, age, index year, and Charlson Comorbidity Index. Participants were included between 1999 and 2010 from the Taiwan National Health Insurance Research Database and were followed through 2013.
The researchers identified participants in whom a hyperglycemic episode developed during follow-up and used Cox regression analysis to calculate the hazard ratio with 95% CI of the hyperglycemic episode incidence rate between the 2 groups.
The results indicated that participants with schizophrenia had an increased risk for hyperglycemic episodes compared with controls after adjusting for baseline demographics and duration of antipsychotic use (4.73 vs 2.43 per 1000 person-years; hazard ratio, 2.16; 95% CI, 1.85-2.51).
The researchers also found that for participants with schizophrenia, a longer duration of antipsychotic use was associated with a reduced risk for hyperglycemic episodes after adjusting for baseline demographics.
The main finding of the study was the higher incidence of hyperglycemic episodes in patients with diabetes and schizophrenia compared with those without schizophrenia. The researchers proposed several possible explanations, including psychiatric symptoms, socioeconomic disparities, stigma from clinicians and a reluctance to treat patients with schizophrenia, and systemic factors like the separate treatment of physical and mental illnesses.
Chen S, Yang Y, Hsu C, Shen Y. Risk of hyperglycaemic crisis episode in diabetic patients with schizophrenia: a nationwide population-based cohort study [published online June 11, 2019]. Diabetes Metab. doi:10.1016/j.diabet.2019.06.001