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Metabolic effects Diabetes

Metabolic effects Diabetes. Rachel Shynn Clinical Nurse Educator Community Mental Health. Diabetes. Diabetes is a chronic disease with serious complications, currently affecting an estimated 1.5 million Australians. About 275 adults develop diabetes every day.

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Metabolic effects Diabetes

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  1. Metabolic effectsDiabetes 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.-educatepatients as well. • Staff should ensure that Pts are followed up by a health care professional knowledgeable about Diabetes. Http://ajp.psychiatryonline.org, 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

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