Abstract
Bipolar patients have a higher risk of type 2 diabetes and obesity, which are associated with cardiovascular diseases as the leading cause of death in this group. Additionally, there is growing evidence that impaired glucose metabolism in bipolar patients is associated with rapid cycling, poor response to mood stabilizers and chronic course of illness. The aim of the study was to assess the prevalence of type 2 diabetes and other types of impaired glucose metabolism in bipolar patients along with an evaluation of the Fasting Triglycerides and Glucose Index (TyG) as a method of the insulin sensitivity assessment. The analysis of fasting glycemia, insulinemia and lipid profile in euthymic bipolar patients was performed, and the Homeostasis model assessment for insulin resistance (HOMA-IR) and TyG were computed. Type 2 diabetes was observed in 9% and insulin resistance with HOMA-IR in 48% of patients. The TyG and HOMA-IR indices were correlated (p < 0.0001), the TyG index value of 4.7 had the highest sensitivity and specificity for insulin resistance detection. The usefulness of TyG in the recognition of insulin resistance in bipolar patients was suggested. The significant role of psychiatrists in the detection and management of impaired glucose metabolism in bipolar patients was presented.
Highlights
According to the literature, the risk of type 2 diabetes is up to three times higher in patients with bipolar disorder than in healthy controls of similar age and sex [1,2,3]
Abdominal circumference, blood pressure, serum lipids and glucose on—(at least) annual basis is recommended in practice guidelines [35,36]
88 subjects, diabetes was detected based on the criterion of random fasting glucose level obtained by venous blood draw in excess of 125 mg/dL (7 mmol/dL) [47] confirmed by repeated abnormal fasting glucose level on another day
Summary
The risk of type 2 diabetes is up to three times higher in patients with bipolar disorder than in healthy controls of similar age and sex [1,2,3]. Over half of bipolar disorder (BD) patients have impaired glucose metabolism, including insulin resistance (IR), impaired glucose tolerance or type 2 diabetes (T2D) [4,5]. This is not entirely related to side effects of pharmacological treatment as even in drug-naïve BD patients IR has been significantly more prevalent than in a healthy population [6]. There is growing evidence that comorbidity of T2D or insulin resistance in bipolar patients is frequently associated with a poor response to mood stabilizing treatment, increased prevalence of rapid cycling and a chronic course of BD. Public Health 2019, 16, 1132; doi:10.3390/ijerph16071132 www.mdpi.com/journal/ijerph
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