Bipolar disorder is linked to increased risk for hyperglycemic crisis in DM

  • Tsai CL & al.
  • J Affect Disord
  • 05.07.2019

  • von Miriam Tucker
  • Clinical Essentials
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Takeaway

  • Patients with diabetes mellitus (DM) and bipolar disorder (BD) are at greater risk for hyperglycemic crisis episode (HCE; diabetic ketoacidosis or hyperosmolar hyperglycemic state) vs those with diabetes and no BD.

Why this matters

  • People with diabetes are at increased risk for BD.

Study design

  • Using national Taiwanese database, 6099 patients with diabetes and BD and 24,378 with diabetes without BD were matched by sex, age, index year, and Charlson Comorbidity Index (CCI) score, and followed up to 14 years.
  • Funding: Taiwan Ministry of Health and Welfare Clinical Trial Center, other non-Pharma institutions.

Key results

  • HCE incidence was 3.84 and 2.71/1000 person-years in BD/DM patients and non-BD/DM controls, respectively.
  • After adjusting for sex, age, CCI score, BD duration, and antipsychotic prescription duration, HCE HR for BD/DM vs non-BD/DM was 1.41 (95% CI, 1.15-1.71).
  • HCE risk (HRs; 95% CIs) was higher for:
    • Males vs females: 1.48 (1.24-1.76);
    • CCI scores 1-2 vs 0: 2.33 (1.92-2.83); 
    • CCI scores ≥3 vs 0: 3.16 (2.30-4.32); and
    • Longest vs shortest antipsychotic use duration groups: 1.32 (95% CI, 1.02-1.72) and 1.57 (1.11-2.23), respectively.  

Limitations

  • Missing information included specific antipsychotics, other medications, body weight, diabetes type, and undiagnosed DM/BD duration lengths.