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.

Keywords

• first episode, mania, diabetes, bipolar

İlk manik dönemde diyabet

Öz

Amaç: Bu çalışmanın amacı ilk manik dönem olgularında diyabet sıklığını araştırmak, diyabet ile maninin klinik özellikleri arasında bir ilişki olup olmadığını incelemektir. Yöntem: Bu çalışmaya DSM-IV tanı ölçütlerine göre mani ölçütlerini karşılayan ve bilgilendirilmiş onamları alınmış, ilk manik dönem tanısı alan 50 olgu ardışık olarak dahil edilmiştir. Tanı görüşmeleri SCID-I ile yapılmış, hasta bilgileri SKIP-TURK ile kaydedilmiş, mani şiddeti YMDÖ (Young Mani Depresyon Ölçeği) ile ölçeklenmiştir. Tüm hastalar açlık kan şekeri (AKŞ), HbA1c ve oral glukoz tolerans testi (OGTT) ile değerlendirilmiştir. Bulgular: İlk manik dönem tanılı olgular arasında diyabet %18 oranında saptanmıştır. Psikotik bulgu diyabet tanılı olgular arasında daha sıktır (p= 0.022). Bu olgularda YMDÖ puanları ile OGTT1 (r= 0.78), OGTT2 (r=0.57) ve HbA1c (r= 0.51) arasında güçlü ve AKŞ (r= 0.039) ile zayıf bir bağıntı saptanmıştır. Aile öyküsünün olmaması ve geç başlangıç yaşı diyabetin öngörücüleri olarak saptanmıştır (OR= 11, Cl %95 2.3-10; OR= 6.8, Cl %95 1.3-4.8). Sonuç: Görece geç başlangıçlı ve aile öyküsü olmayan manik hastalarda diyabet tanısı hatırlanmalı ve araştırılmalıdır.

Anahtar Kelimeler

• ilk dönem, mani, diyabet, iki uçlu

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