1. Metabolic effects Diabetes
Rachel Shynn
Clinical Nurse Educator
Community Mental Health

2. Diabetes
Diabetes is a chronic disease with serious complications, currently affecting an estimated 1.5 million Australians. About 275 adults develop diabetes every day.
Research shows that most Australians think diabetes is not a serious illness, and believe they have a lower risk of developing it than they actually do .
Diabetes Australia

3. Diabetes Type 2: lifestyle and other factors - Diet controlled
- Diet and Medication controlled
- Insulin required.
Type 1: autoimmune condition
Gestational Diabetes

4. Diabetes Risk Factors Family History Birth weight Ethnicity Age
Obesity
Physical inactivity
Diet

5. Other Risk Factors Increase risk with mental illness and schizophrenia
schizophrenic patients have an increased prevalence of diabetes(15-18%).
2-4 times the normal population
High prevalence of undiagnosed diseases including diabetes
Diabetes, severe Mental illness and Antipsychotic Drugs: The Myths Unravelled: Dr Richard Holt.

6. Why increase Risk factors with schizophrenia
Genetics
low birth rate
Lifestyle
Illness timeline
Drugs (illicit, alcohol, prescribed)
High BMI = increase risk (prior to diagnosis and starting antipsychotics)

7. Medications Oral Hypoglycaemics
insulin secretogogues. Stimulate pancreatic insulin secretion, eg Diamicron
insulin sensitisers. Reduce insulin resistance. Eg Metformin
Acarbose. Inhibits enzymes that break down complex carbohydrates(CHO) in gut wall, delays CHO digestion and glucose absorption, eg Glocobay.
(Lyn Billington LRH pharmacist)

8. Clinical implications
Need to screen all patients for diabetes
Need to implement lifestyle modifications
Need to manage diabetes

9. Treatment Recommendations
Baseline measure of plasma glucose level (fasting plasma preferred).collected prior to antispychotics
Pts who have risk factors for Diabetes should have fasting plasma levels monitored 4 months after starting medication then yearly.
Staff should be aware of the symptoms of new onset diabetes.-educate patients as well.
Staff should ensure that Pts are followed up by a health care professional knowledgeable about Diabetes. pg1338

10. Summary Schizophrenia is associated with DM Complex disease to manage
Patients with schizophrenia requiring screening for diabetes.
Patients with Diabetes starting on antipsychotics may notice an altered glucose control.
Importance of treating mental state.
It is a multi-discipline approach
Diabetes, severe Mental illness and Antipsychotic Drugs: The Myths Unravelled: Dr Richard Holt.

11. Diabetes
“Diabetes is a disease which often shows in families which insanity prevails”
Henry Maudsley
1879

12. Diabetes