Background and objectivesOver the past few decades,
research has revealed complex interactions between
type 2 diabetes mellitus (T2DM) and a wide range of comorbid conditions. The present
paper sought to examine the relationship between
bipolar disorder and T2DM and clarify the clinical impact of
therapeutic interventions, highlighting the interpretation and implications of recent
literature reports.MethodsThe
PubMed electronic database was searched for
keywords
bipolar disorder AND diabetes OR
glucose. Based on this
literature search, 15 meta-analyses/systematic reviews and numerous
research studies were identified that examined interrelationships between
bipolar disorders and T2DM.ResultsPatients with
bipolar disorder have higher rates of T2DM compared to the general
population. Further, type 2 diabetic
patients with comorbid
bipolar disorder often experience deteriorated long-term
glucose control and increased cardiovascular
morbidity and
mortality. Recent
literature suggests
shared risk factors and underlying
disease mechanisms. In addition, genetic factors, sedentary
life-style, lack of
exercise, increased simple
carbohydrate intake,
adverse effects of bipolar
pharmacotherapy, and bipolar
depressive symptoms phenomenology may
affect glucose metabolism.ConclusionsThe observed bidirectional interaction merits
screening for
psychiatric disorders in T2DM and vice versa to allow for early
detection and
treatment of this at
risk population. Selection of
drugs with neutral metabolic effects and
dose individualization hold significant promise for optimizing
therapy with
antipsychotic and
antidiabetic agents. (AU)