Diabetes in first manic episode

Abstract

Objective: The aim of this study was to investigate the frequency of diabetes during the first manic episode and explore, whether a relationship between diabetes and clinical features of mania exists or not. Method: Fifty consecutive patients, who were diagnosed with bipolar disorder first manic episode according to DSM-IV diagnostic criteria and gave written informed consent were included in this study. The interview to confirm diagnosis was carried out by using the related module of The Structured Clinical Interview for DSM-IV, the patient information was recorded on SKIP-TURK forms, and the severity of mania was determined by using Young Mania Rating Scale. Fasting blood glucose and HbA1c levels of all patients were measured and their oral glucose tolerance tests were performed. Results: The frequency of diabetes in bipolar first manic episode patients was determined as 18%. Psychotic symptoms were more frequent among the diabetic patients (p= 0.022). In these patients, strong correlations between YMRS scores and OGTT1 (r= 0.78), OGTT2 (r= 0.57) and HbA1c (r= 0.51) were observed, whereas, a weak correlation was present between bipolar first manic episode patients and FBG (r= 0.039). Negative family history and later age of onset of illness were determined as the predictors of diabetes (OR= 11, 2.3-10, p< 0.001; OR= 6.8, 1.3-4.8, p= 0.009). Conclusion: Diabetes is a diagnosis that should be kept in mind and investigated in the manic patients with relatively late age of onset and negative family history.