Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
University Hospital Southampton NHS Trust, The IDS Building (MP887), Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK.
Curr Diab Rep. 2019 Sep 2;19(10):96. doi: 10.1007/s11892-019-1220-8.
The prevalence of diabetes is 2-3-fold higher in people with severe mental illness than the general population. There are concerns that antipsychotics increase the risk of diabetes. This review will examine the latest epidemiological studies linking antipsychotics and diabetes, as well as the mechanisms underlying the association and the clinical implications to minimise the impact of antipsychotics on metabolic health.
Although there is an increased risk of diabetes in people with first-episode psychosis, the prevalence increases rapidly after antipsychotics are started. Antipsychotics likely increase the risk of diabetes through weight gain and directly by adversely affecting insulin sensitivity and secretion. It is important to implement measures to prevent diabetes, to screen for diabetes to ensure prompt diagnosis and to provide effective diabetes care. Further research is needed to understand how antipsychotics cause diabetes and to improve the clinical management of diabetes in people with severe mental illness.
严重精神疾病患者的糖尿病患病率比一般人群高 2-3 倍。人们担心抗精神病药会增加患糖尿病的风险。本综述将探讨最新的流行病学研究，这些研究将探讨抗精神病药与糖尿病之间的联系，以及这种关联的潜在机制和临床意义，以尽量减少抗精神病药对代谢健康的影响。
尽管首发精神病患者发生糖尿病的风险增加，但在开始使用抗精神病药后，这种风险迅速增加。抗精神病药可能通过体重增加以及直接影响胰岛素敏感性和分泌来增加患糖尿病的风险。重要的是要采取措施预防糖尿病，筛查糖尿病以确保及时诊断，并提供有效的糖尿病护理。需要进一步的研究来了解抗精神病药如何导致糖尿病，并改善严重精神疾病患者的糖尿病临床管理。
