Diabetes and Glucose Intolerance in Schizophrenic Patients in the Preantipsychotic

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Early reports dating back to the 1920s, before the use of antipsychotic agents, suggest that individuals with schizophrenia and other psychotic dis orders exhibited an elevated risk for developing glucose intolerance or diabetes mellitus (Braceland et al. 1945; Brambilla et al. 1976; Haupt and Newcomer 2001; Marinow 1971; Schwartz and Munoz 1968; Waitzkin 1966a, 1966b). Specifically, the reports indicate a pattern of insulin resistance in schizophrenic patients independent of adverse medication effects (Haupt and Newcomer 2001). These studies, however, suffer from several methodological problems: there are flaws in the diagnostic criteria for schizophrenia, and they do not control for age, weight, fat distribution, ethnicity, diet, or exercise, all of which are variables now known to play a role in an individual's risk for developing glucoregulatory disturbances (Haupt and Newcomer 2001). Because no well-controlled studies exist, whether individuals with schizophrenia, when unmedicated, are at increased risk for developing diabetes compared with the general population remains a matter of debate.

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