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Diabetes in first manic episode

Year 2013, Volume: 3 Issue: 1, 17 - 22, 01.01.2013
https://doi.org/10.5455/jmood.20121003054610

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.

References

  • Oulis P, Karapoulios E, Kouzoupis V, Masdrakis VG, Kontoangelos KA, Makrilakis K. Oxcarbazepine as monotherapy of acute mania in insufficiently controlled type-1 diabetes mellitus: a case-report. Ann Gen Psychiatry. 2007;6:25.
  • McIntyre RS, Nguyen HT, Soczynska JK, Lourenco MT, Woldeyohannes HO, Konarski JZ. Medical and substance-related comorbidity in bipolar disorder: translational research and treatment opportunities. Dialogues Clin Neurosci. 2008;10:2032
  • McIntyre RS, Konarski JZ, Misener VL, Kennedy SH. Bipolar disorder and diabetes mellitus: epidemiology, etiology, and treatment implications. Ann Clin Psychiatry. 2005;17:83-93.
  • Kesebir S, Gençer AG. Bipolar disorder and diabetes mellitus. Current Approaches in Psychiatry. 2010;2:66-74.
  • Castilla-Puentes R. Effects of psychotropics on glycosylated hemoglobin (HbA1c) in a cohort of bipolar patients. Bipolar Disord. 2007;9:772-778.
  • Kim B, Kim S, McIntyre RS, Park HJ, Kim SY, Joo HY. Correlates of metabolic syndrome in bipolar disorder at initiation of acute phase treatment. Psychiatry Investig. 2009;6:78-84.
  • Ruzickova M, Slaney C, Garnham J, Alda M. Clinical features of bipolar disorder with and without comorbid diabetes mellitus. Can J Psychiatry. 2003;48:458-461.
  • Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Krishnan KR. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;158:175-189.
  • Gautam S. Fourth Revolution of Psychiatry: Adressing comorbidity with chronic physical disorders. Indian J Psychiatry. 2010;52:213-9.
  • Fagiolini A, Goracci A. The effects of undertreated chronic medical illnesses in patients with severe mental disorders. J Clin Psychiatry. 2009;70:22-29.
  • Regenold WT, Kling AM, Hauser P. Elevated sorbitol concentration in the cerebrospinal fluid of patients with mood disorders. Psychoneuroendocrinology. 2000;25:593-606.
  • Regenold WT, Hisley KC, Phatak P, Marano CM, Obuchowski A, Lefkowitz DM. Relationship of cerebrospinal fluid glucose metabolites to MRI deep white matter hyperintensities and treatment resistance in bipolar disorder patients. Bipolar Disord. 2008;10:753-764.
  • Rayasam GV, Tulasi VK, Sodhi R, Davis JA, Ray A. Glycogen synthase kinase 3: more than a namesake. Br J Pharmacol. 2009;156:885-898.
  • Patel DS, Dessalew N, Igbal P, Bharatam PV. Structure-based approaches in the design of GSK-3 selective inhibitors. Curr Protein Pept Sci. 2007;8:352-364.
  • Hunt NJ. Hypoglycemic effect of lithium. Biol Psychiatry. 1987;22:798-9.
  • Hajek T, Hahn M, Slaney C, Garnham J, Green J, Ruzickova M. Rapid cycling bipolar disorders in primary and tertiary care treated patients. Bipolar Disord. 2008;10:495-502.
  • McIntyre RS, Soczynska JK, Beyer JL, Woldeyohannes HO, Law CWY, Miranda A. Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry. 2007;20:406-416.
  • Wang SH, Sun ZL, Guo YJ, Yuan Y, Yang BQ. Diabetes impairs hippocampal function via advanced glycation end product mediated new neuron generation in animals with diabetes-related depression. Toxicol Sci. 2009;111:72-9.
  • McIntyre RS, Danilewitz M, Liauw SS, Kemp DE, Nguyen HT, Kahn LS, Kucyi A, Soczynska JK, Woldeyohannes HO, Lachowski A, Kim B, Nathanson J, Alsuwaidan M, Taylor VH. Bipolar disorder and metabolic syndrome: an international perspective. J Affect Disord. 2010;126:366-87.
  • Ross KA. Evidence for somatic gene conversion and deletion in bipolar disorder, chron’s disease, coronary arteria disease, hypertension, rheumatoid arthritis, type 1 and 2 diabetes. BMC Med. 2011;3: 9-12.
  • Lehne B, Lewis CM, Schlitt T. Exome localisation of complex disease association signals. BMC Genomics. 2011;12:92.
  • So HC, Gai AH, Cherny SS, Sham PC. Evaluating the heritability explained by known susceptibility variants: a survey of ten complex diseases. Genetic Epidemiol. 2011; doi:10.1002/gepi.20579.
  • First MB, Spitzer RL, Gibbon M. Structured Clinical Interview for DSM-IV Clinical Version (SCID-I / CV), 1997, Washington DC, American Psychiatric Press.
  • Özkürkçügil A, Aydemir Ö, Yıldız M. DSM-IV Eksen I bozuklukları için yapılandırılmış klinik görüşmenin Türkçe’ye uyarlanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:233-236.
  • Özerdem A, Yazıcı O, Tunca Z. Mood Disorders Study Group, Psychiatric Association of Turkey and K Tırpan. Establishment of Computerized Registry Program for Bipolar Illnes in Turkey: SKİPTÜRK. J Affect Disord. 2004;84: 82-86.
  • Young RC, Biggs JT, Ziegler VE. A Rating Scala for Mania: Reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-435.
  • Karadağ F, Oral ET, Yalçın F. Young Mani Derecelendirme Ölçeği’nin Türkiye’de geçerlik ve güvenirliği. Türk Psikiyatri Dergisi. 2001;13:107-114.
  • Smith GC, Chaussade C, Vickers M, Jensen J, Shepherd PR. Atypical antipsychotic drugs induce derangements in glucose homeostasis by acutely increasing glucagon secretion and hepatic glucose output in the rat. Diabetologia. 2008;51:2309-2317.
  • American Diabetes Association. Clinical Practice Recommendations. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2007;30:42-47.
  • Chien IC, Chang KC, Lin CH, Chou YJ, Chou P. Prevalence of diabetes in patients with bipolar disorder in Taiwan: a populationbased national health insurance study. Gen Hosp Psychiatry. 2010; 32:577-582.
  • Kesebir S, Aksoy AE, Gençer AG, Usta H, Elbay RY, Şayakçı S, Bilici M. Psikiyatrik bozukluklarda III. Eksen komorbiditesi. Ulusal Psikiyatri Kongresi. 2010, İzmir, Turkey. SB 13, p:339, s:46.
  • Langevin R, Langevin M, Curnoe S, Bain J. The prevalence of diabetes among sexual and violent offenders and its co-occurrence with cognitive impairment, mania, psychotic symptoms and aggressive behavior. Int J Prison Health. 2008;4:83-95.
  • Goodwin FK, Jamison KR. Manic-Depressive Illness, Oxford University Press, New York, 1990.
  • Akiskal HS, Bourgeois ML, Angst J, Post R, Möller HJ, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorder. J Affect Disord. 2006;59:5-30.
  • Kesebir S, Şayakçı S. Late onset bipolar disorders between first episode patients. SB 14, p: 23. 46. National Psychiatry Congres 2010, İzmir, Turkey.
  • Benazzi F. Classifying mood disorders by age-at-onset instead of polarity. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33:86
  • Pekary AE, Stevens SA, Blood JD, Sattin A. Rapid modulation of TRH and TRH-like peptide release in rat brain, pancreas, and testis by a GSK-3beta inhibitor. Peptides. 2010;31:1083-1093.

İlk manik dönemde diyabet

Year 2013, Volume: 3 Issue: 1, 17 - 22, 01.01.2013
https://doi.org/10.5455/jmood.20121003054610

Abstract

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.

References

  • Oulis P, Karapoulios E, Kouzoupis V, Masdrakis VG, Kontoangelos KA, Makrilakis K. Oxcarbazepine as monotherapy of acute mania in insufficiently controlled type-1 diabetes mellitus: a case-report. Ann Gen Psychiatry. 2007;6:25.
  • McIntyre RS, Nguyen HT, Soczynska JK, Lourenco MT, Woldeyohannes HO, Konarski JZ. Medical and substance-related comorbidity in bipolar disorder: translational research and treatment opportunities. Dialogues Clin Neurosci. 2008;10:2032
  • McIntyre RS, Konarski JZ, Misener VL, Kennedy SH. Bipolar disorder and diabetes mellitus: epidemiology, etiology, and treatment implications. Ann Clin Psychiatry. 2005;17:83-93.
  • Kesebir S, Gençer AG. Bipolar disorder and diabetes mellitus. Current Approaches in Psychiatry. 2010;2:66-74.
  • Castilla-Puentes R. Effects of psychotropics on glycosylated hemoglobin (HbA1c) in a cohort of bipolar patients. Bipolar Disord. 2007;9:772-778.
  • Kim B, Kim S, McIntyre RS, Park HJ, Kim SY, Joo HY. Correlates of metabolic syndrome in bipolar disorder at initiation of acute phase treatment. Psychiatry Investig. 2009;6:78-84.
  • Ruzickova M, Slaney C, Garnham J, Alda M. Clinical features of bipolar disorder with and without comorbid diabetes mellitus. Can J Psychiatry. 2003;48:458-461.
  • Evans DL, Charney DS, Lewis L, Golden RN, Gorman JM, Krishnan KR. Mood disorders in the medically ill: scientific review and recommendations. Biol Psychiatry. 2005;158:175-189.
  • Gautam S. Fourth Revolution of Psychiatry: Adressing comorbidity with chronic physical disorders. Indian J Psychiatry. 2010;52:213-9.
  • Fagiolini A, Goracci A. The effects of undertreated chronic medical illnesses in patients with severe mental disorders. J Clin Psychiatry. 2009;70:22-29.
  • Regenold WT, Kling AM, Hauser P. Elevated sorbitol concentration in the cerebrospinal fluid of patients with mood disorders. Psychoneuroendocrinology. 2000;25:593-606.
  • Regenold WT, Hisley KC, Phatak P, Marano CM, Obuchowski A, Lefkowitz DM. Relationship of cerebrospinal fluid glucose metabolites to MRI deep white matter hyperintensities and treatment resistance in bipolar disorder patients. Bipolar Disord. 2008;10:753-764.
  • Rayasam GV, Tulasi VK, Sodhi R, Davis JA, Ray A. Glycogen synthase kinase 3: more than a namesake. Br J Pharmacol. 2009;156:885-898.
  • Patel DS, Dessalew N, Igbal P, Bharatam PV. Structure-based approaches in the design of GSK-3 selective inhibitors. Curr Protein Pept Sci. 2007;8:352-364.
  • Hunt NJ. Hypoglycemic effect of lithium. Biol Psychiatry. 1987;22:798-9.
  • Hajek T, Hahn M, Slaney C, Garnham J, Green J, Ruzickova M. Rapid cycling bipolar disorders in primary and tertiary care treated patients. Bipolar Disord. 2008;10:495-502.
  • McIntyre RS, Soczynska JK, Beyer JL, Woldeyohannes HO, Law CWY, Miranda A. Medical comorbidity in bipolar disorder: re-prioritizing unmet needs. Curr Opin Psychiatry. 2007;20:406-416.
  • Wang SH, Sun ZL, Guo YJ, Yuan Y, Yang BQ. Diabetes impairs hippocampal function via advanced glycation end product mediated new neuron generation in animals with diabetes-related depression. Toxicol Sci. 2009;111:72-9.
  • McIntyre RS, Danilewitz M, Liauw SS, Kemp DE, Nguyen HT, Kahn LS, Kucyi A, Soczynska JK, Woldeyohannes HO, Lachowski A, Kim B, Nathanson J, Alsuwaidan M, Taylor VH. Bipolar disorder and metabolic syndrome: an international perspective. J Affect Disord. 2010;126:366-87.
  • Ross KA. Evidence for somatic gene conversion and deletion in bipolar disorder, chron’s disease, coronary arteria disease, hypertension, rheumatoid arthritis, type 1 and 2 diabetes. BMC Med. 2011;3: 9-12.
  • Lehne B, Lewis CM, Schlitt T. Exome localisation of complex disease association signals. BMC Genomics. 2011;12:92.
  • So HC, Gai AH, Cherny SS, Sham PC. Evaluating the heritability explained by known susceptibility variants: a survey of ten complex diseases. Genetic Epidemiol. 2011; doi:10.1002/gepi.20579.
  • First MB, Spitzer RL, Gibbon M. Structured Clinical Interview for DSM-IV Clinical Version (SCID-I / CV), 1997, Washington DC, American Psychiatric Press.
  • Özkürkçügil A, Aydemir Ö, Yıldız M. DSM-IV Eksen I bozuklukları için yapılandırılmış klinik görüşmenin Türkçe’ye uyarlanması ve güvenilirlik çalışması. İlaç ve Tedavi Dergisi. 1999;12:233-236.
  • Özerdem A, Yazıcı O, Tunca Z. Mood Disorders Study Group, Psychiatric Association of Turkey and K Tırpan. Establishment of Computerized Registry Program for Bipolar Illnes in Turkey: SKİPTÜRK. J Affect Disord. 2004;84: 82-86.
  • Young RC, Biggs JT, Ziegler VE. A Rating Scala for Mania: Reliability, validity and sensitivity. Br J Psychiatry. 1978;133:429-435.
  • Karadağ F, Oral ET, Yalçın F. Young Mani Derecelendirme Ölçeği’nin Türkiye’de geçerlik ve güvenirliği. Türk Psikiyatri Dergisi. 2001;13:107-114.
  • Smith GC, Chaussade C, Vickers M, Jensen J, Shepherd PR. Atypical antipsychotic drugs induce derangements in glucose homeostasis by acutely increasing glucagon secretion and hepatic glucose output in the rat. Diabetologia. 2008;51:2309-2317.
  • American Diabetes Association. Clinical Practice Recommendations. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2007;30:42-47.
  • Chien IC, Chang KC, Lin CH, Chou YJ, Chou P. Prevalence of diabetes in patients with bipolar disorder in Taiwan: a populationbased national health insurance study. Gen Hosp Psychiatry. 2010; 32:577-582.
  • Kesebir S, Aksoy AE, Gençer AG, Usta H, Elbay RY, Şayakçı S, Bilici M. Psikiyatrik bozukluklarda III. Eksen komorbiditesi. Ulusal Psikiyatri Kongresi. 2010, İzmir, Turkey. SB 13, p:339, s:46.
  • Langevin R, Langevin M, Curnoe S, Bain J. The prevalence of diabetes among sexual and violent offenders and its co-occurrence with cognitive impairment, mania, psychotic symptoms and aggressive behavior. Int J Prison Health. 2008;4:83-95.
  • Goodwin FK, Jamison KR. Manic-Depressive Illness, Oxford University Press, New York, 1990.
  • Akiskal HS, Bourgeois ML, Angst J, Post R, Möller HJ, Hirschfeld R. Re-evaluating the prevalence of and diagnostic composition within the broad clinical spectrum of bipolar disorder. J Affect Disord. 2006;59:5-30.
  • Kesebir S, Şayakçı S. Late onset bipolar disorders between first episode patients. SB 14, p: 23. 46. National Psychiatry Congres 2010, İzmir, Turkey.
  • Benazzi F. Classifying mood disorders by age-at-onset instead of polarity. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33:86
  • Pekary AE, Stevens SA, Blood JD, Sattin A. Rapid modulation of TRH and TRH-like peptide release in rat brain, pancreas, and testis by a GSK-3beta inhibitor. Peptides. 2010;31:1083-1093.
There are 37 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ali Görkem Gençer This is me

Sermin Kesebir This is me

Enver Demirel Yılmaz This is me

Publication Date January 1, 2013
Published in Issue Year 2013 Volume: 3 Issue: 1

Cite

APA Gençer, A. G., Kesebir, S., & Yılmaz, E. D. (2013). İlk manik dönemde diyabet. Journal of Mood Disorders, 3(1), 17-22. https://doi.org/10.5455/jmood.20121003054610
AMA Gençer AG, Kesebir S, Yılmaz ED. İlk manik dönemde diyabet. Journal of Mood Disorders. January 2013;3(1):17-22. doi:10.5455/jmood.20121003054610
Chicago Gençer, Ali Görkem, Sermin Kesebir, and Enver Demirel Yılmaz. “İlk Manik dönemde Diyabet”. Journal of Mood Disorders 3, no. 1 (January 2013): 17-22. https://doi.org/10.5455/jmood.20121003054610.
EndNote Gençer AG, Kesebir S, Yılmaz ED (January 1, 2013) İlk manik dönemde diyabet. Journal of Mood Disorders 3 1 17–22.
IEEE A. G. Gençer, S. Kesebir, and E. D. Yılmaz, “İlk manik dönemde diyabet”, Journal of Mood Disorders, vol. 3, no. 1, pp. 17–22, 2013, doi: 10.5455/jmood.20121003054610.
ISNAD Gençer, Ali Görkem et al. “İlk Manik dönemde Diyabet”. Journal of Mood Disorders 3/1 (January 2013), 17-22. https://doi.org/10.5455/jmood.20121003054610.
JAMA Gençer AG, Kesebir S, Yılmaz ED. İlk manik dönemde diyabet. Journal of Mood Disorders. 2013;3:17–22.
MLA Gençer, Ali Görkem et al. “İlk Manik dönemde Diyabet”. Journal of Mood Disorders, vol. 3, no. 1, 2013, pp. 17-22, doi:10.5455/jmood.20121003054610.
Vancouver Gençer AG, Kesebir S, Yılmaz ED. İlk manik dönemde diyabet. Journal of Mood Disorders. 2013;3(1):17-22.