Affective disorders, diabetes mellitus and lithium.

There appears to be an association between affective disorders and diabetes mellitus independent of the use of lithium in treatment. Prior studies have suggested that lithium treatment may impair glucose tolerance or produce frank diabetes in certain patients. Metabolic complications of the diabetic state, such as hyperosmolality and salt depletion increase lithium absorption and the risk of toxicity even at generally acceptable serum levels. The management of patients with diabetes and affective disorders on prophylactic lithium is discussed.