Last update:
19-Mar-2025

The prevalence of diabetes is two to three times higher in people with severe mental illness than in the general population. Microvascular and macrovascular complications of diabetes are more common and more severe in people with severe mental illnesses (SMI), and are associated with premature death. The etiology of diabetes in people with SMI is complex and multifactorial. The mechanisms include both the common diabetic factors, as well as disease-specific factors related to genetics and pharmacotherapy. In addition, socioeconomic factors, as well as reduced access to health services were found to play an important role in the development of diabetes. Numerous studies in recent years have suggested various mechanisms that correlate diabetes to serious mental illness. Genetic, pathophysiological, environmental and pharmacological factors form the basis of the association between these conditions. All the antipsychotic agents that have been discovered to date contribute to varying degrees to the risk of developing diabetes, whilst other medications such as tricyclic antidepressants and serotonin-norepinephrine reuptake inhibitors have also been found to contribute to deregulation of glycemic control. Although the current guidelines of diabetes management in people with severe mental illness are similar to those in the general population, relatively often the results of treatment are inadequate; therefore, special emphasis on this group of patients is required.

Key words: Antidepressants, Antidiabetic agents, Diabetes mellitus, Severe mental illness antipsychotics.