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Published Online: 24 January 2018

Early Combination Therapy for Type 2 Diabetes Mellitus and Common Comorbid Mental Disorders

Abstract

The relationship between type 2 diabetes mellitus and antipsychotic use by schizophrenia patients is recognized but not well understood. This article reviews the literature regarding metabolic interactions, pathological pathways, and protocols for screening, monitoring, and using combination therapy for individuals with type 2 diabetes mellitus and common comorbid mental health conditions. Because primary care physicians manage patients with both mental and general medical illnesses, such as diabetes, understanding their perspectives on the challenges and facilitators of the care of these patients is critical to improving clinical outcomes. Although the relationship between type 2 diabetes mellitus and antipsychotic use by schizophrenia patients has been recognized, clinical guidelines for their treatment are not recent. Individuals with mental disorders present a vulnerable population with high medical needs that are often mistreated or missed. Given the significant contribution of metabolic syndrome and comorbid diabetes mellitus to morbidity and mortality of such patients, ongoing primary care should be coordinated between general practitioners and mental health professionals to prevent serious complications and adverse medication side effects.

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History

Published in print: Winter 2018
Published online: 24 January 2018

Keywords

  1. Type 2 Diabetes Mellitus
  2. Schizophrenia
  3. Depression
  4. Antipsychotics

Authors

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Rahn Kennedy Bailey, M.D.
Dr. Bailey and Dr. Sharpe are with the Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Bailey and Dr. Sharpe are also with the Department of Psychiatry and Behavioral Medicine, Wake Forest Baptist Health, Winston-Salem, North Carolina, where Dr. Ringel and Dr. Zeeshan are externs.
Daphne Kaye Sharpe, D.N.P. [email protected]
Dr. Bailey and Dr. Sharpe are with the Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Bailey and Dr. Sharpe are also with the Department of Psychiatry and Behavioral Medicine, Wake Forest Baptist Health, Winston-Salem, North Carolina, where Dr. Ringel and Dr. Zeeshan are externs.
Marianna Ringel, M.D.
Dr. Bailey and Dr. Sharpe are with the Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Bailey and Dr. Sharpe are also with the Department of Psychiatry and Behavioral Medicine, Wake Forest Baptist Health, Winston-Salem, North Carolina, where Dr. Ringel and Dr. Zeeshan are externs.
Abeer Zeeshan, M.D., M.B.B.S.
Dr. Bailey and Dr. Sharpe are with the Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina. Dr. Bailey and Dr. Sharpe are also with the Department of Psychiatry and Behavioral Medicine, Wake Forest Baptist Health, Winston-Salem, North Carolina, where Dr. Ringel and Dr. Zeeshan are externs.

Notes

Send correspondence to Dr. Sharpe (e-mail: [email protected]).

Funding Information

The authors report no financial relationships with commercial interests.

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