Abstract
Background: Diabetes is a public health problem worldwide and in sub-Saharan African countries such as Cameroon. According to many studies, the use of antipsychotic drugs increases the risk of developing diabetes mellitus by 2 to 3 times more in people with psychotic disorders than in the general population. The present study aimed to assess the influence of antipsychotic drugs used on the risk of developing diabetes and to identify other factors predictive of abnormal blood glucose levels in patients suffering from psychosis. Methods: A cross-sectional study was conducted from the 3rd to the 19th of January 2018. Patients aged at least 18 years old suffering from psychosis and undiagnosed as diabetic before initiation of antipsychotic treatment were recruited at the Jamot Hospital in Yaoundé. A questionnaire was used to collect sociodemographic, anthropometric, and clinical data. The Chi-Square test was used to assess the relationship between hyperglycemia and categorical variables and the multivariate logistic regression model was used to determine independent predictors of hyperglycemia through the Statistical Package for the Social Sciences (SPSS) version 20.0. Results: A total of 82 patients were included in the study (41 males and 41 females). The fasting blood sugar ≥100 mg/dL appeared to be higher but not significant in patients on atypical antipsychotic therapy (124.74±23.31mg/dL) compared to patients on typical antipsychotic therapy (115.74±18.63 mg/dL); with a positive and non-significant correlation between hyperglycemia and duration of treatment (r=0.215; p=0.053). However, in both typical and atypical antipsychotic patients, fasting glucose sugar levels between 110-125mg/dL were observed at the same level (118.07±4.84 mg/dL and 118.09±3.41mg/dL respectively). Male sex (OR=1.41; 95% CI 0.54-3.64), age group < 35 years (OR=1.84; 95% CI 0.69-4.88), single (OR=2.18; 95% CI 0.83-5.67), typical antipsychotic drugs (OR=1.12; 95% CI 0.42-3.01), schizophrenia (OR=1.80; 95% CI 0.25-12.84) and bipolar disorder (OR=1.50; 95% CI 0.14-15.46) were independent predictors of hyperglycemia in those patients. Conclusion: Regular monitoring of anthropometric and clinical parameters should be assigned to people suffering from psychotic disorders and under treatment. Therefore, they should benefit from good management of the risk factors for diabetes to prevent the onset of the disease and avoid increased morbidity and mortality in this vulnerable population.
Highlights
Diabetes is a metabolic and endocrine disorder characterized by chronic hyperglycemia resulting from a defect in insulin action and/or secretion [1]
Anthropometric and clinical characteristics of the study population as a function of treatment duration (Table 2) show that the mean age, weight, Body Mass Index (BMI), diastolic blood pressure, and blood glucose levels were higher but not significant in patients on antipsychotic therapy for more than 6 months compared to patients on antipsychotic therapy of 6 months or less
In terms of the type of antipsychotic medication given to patients, 65.1% of patients were on typical antipsychotic medication, 40% were on treatment for 6 months or less and 59.3% were on treatment for more than 6 months, while 33.7% of patients were on atypical antipsychotic medication, 50% were on treatment for 6 months or less and 50% were on treatment for more than 6 months
Summary
Diabetes is a metabolic and endocrine disorder characterized by chronic hyperglycemia resulting from a defect in insulin action and/or secretion [1]. The use of antipsychotic drugs increases the risk of developing diabetes mellitus by 2 to 3 times more in people with psychotic disorders than in the general population. The present study aimed to assess the influence of antipsychotic drugs used on the risk of developing diabetes and to identify other factors predictive of abnormal blood glucose levels in patients suffering from psychosis. Conclusion: Regular monitoring of anthropometric and clinical parameters should be assigned to people suffering from psychotic disorders and under treatment. They should benefit from good management of the risk factors for diabetes to prevent the onset of the disease and avoid increased morbidity and mortality in this vulnerable population
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