August 22, 2014

Today is the American Diabetes Association’s Alert Day, its annual day to promote screening for diabetes. Diabetes is a serious health condition that reminds me of many psychiatric illnesses—it is serious, has substantial risks and requires attention. Diabetes is also like serious psychiatric disorders in that daily choices can make a difference to improve outcomes. For diabetes, an exercise program can improve or in some cases reverse the development of diabetes. (Exercise can also be an important part of treatment for mental health conditions).

There is another connection: many people with psychiatric illnesses are at increased risk of diabetes and the medications used to treat those conditions often confer additional risk. These risks should be weighed against the benefits of these medications, which can also be significant. The most common mechanism of the increased risk is weight gain, which is the underlying cause of most of the rise in adult onset diabetes. Many psychiatric medications can lead to an increase in weight, which in turn raises the risk of diabetes. Second generation antipsychotics can be a particular concern in this area, but they do not all bring the same risk. For more information on the risks associated with many of these medicines, see NAMI’s information on diabetes and mental illness.

Another piece of the puzzle is that the research literature shows that individuals living with mental illness do not get screened adequately. This could be caused by many things, including inadequate care. NAMI members have helped to change many aspects of the health care world, and by advocating for screening we can help primary care doctors approach the problem. If you cannot join in the ADA screening day, ask for a screening at your next appointment. It is a simple blood test. It could be lifesaving, especially if you are in one of the ADA risk categories or are taking psychiatric medications.

Also, take a look at the SAMSHA summary of the implications of diabetes for people living with a serious mental illness that was published in fall 2013 for more information on the relationship between diabetes and mental illness.

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