Bipolar disorder patients often develop diabetes, and the medications used to treat bipolar symptoms may be to blame.
By Dennis Thompson Jr.
Medically reviewed by Pat F. Bass III, MD, MPH
Can Bipolar Disorder Lead to Diabetes? People with bipolar disorder struggle with many side effects related to both their mental illness and their treatment therapies. In recent years, diabetes has emerged as one of the more serious health risks for people with bipolar disorder.
Diabetes is found in people with bipolar disorder nearly three times more often than in the general population. This has prompted much research into the link between diabetes and bipolar disorder. Studies have found that people with bipolar disorder tend to be overweight or obese, a key risk factor in developing diabetes. Research into potential causes of this weight gain has identified the medications used to treat bipolar disorder as the likely culprits.
Bipolar Disorder: The Obesity and Diabetes Chain Reaction
Being overweight or obese is a primary risk factor for developing type 2 diabetes. People who carry extra body weight and body fat, particularly around the abdomen, are less able to properly control their blood sugar. That’s because extra body fat interferes with the function of insulin, the naturally occurring hormone produced in the pancreas that helps cells convert sugar into energy or store it away as fat. The body is forced to produce more insulin to handle the conversion. If this situation continues without treatment, permanent damage to the pancreas can occur.
The percentage of patients with bipolar disorder who are overweight is remarkable: Studies have found that between 54 and 68 percent of bipolar patients are either overweight or obese, with obesity affecting about one-fourth of patients and more women than men.
Obesity is one of the criteria for metabolic syndrome, the health condition that includes these serious health risks:
- High levels of LDL, the “bad” cholesterol
- High blood pressure
- Elevated blood glucose levels
- Abdominal fat
Metabolic syndrome places people at risk for diabetes, cardiovascular disease, and a host of other systemic illnesses. A Spanish study of patients with bipolar disorder found that they were 58 percent more likely to have metabolic syndrome than the rest of the population.
Causes of Obesity and Diabetes in Bipolar Patients
Researchers have paid close attention to the causes of obesity in bipolar patients in recent years. The use of bipolar medications has been singled out as a likely factor in weight gain, although some doctors suspect there may be a genetic component involved as well.
Research has linked the use of lithium and antiepileptic medications in particular with weight gain. One review of 24 medication trials found that these drugs caused significant weight gain in pediatric bipolar patients 75 percent of the time.
Antipsychotic medications also are used to treat bipolar patients, and they too have been linked with weight gain, particularly second-generation drugs like clozapine and olanzapine. The same review of medication trials found that bipolar patients gained more weight when taking second-generation antipsychotics and gained an extreme amount of weight when taking antipsychotics along with mood-stabilizing medications.
A genetic link between bipolar disorder and diabetes is suspected because common genetic factors between the two can cause a rare disorder called Wolfram syndrome. People with Wolfram syndrome develop diabetes and exhibit bipolar symptoms. However, researchers have not extensively explored this potential genetic connection.
Due to the clear link between bipolar medications and weight gain, researchers are urging doctors to closely monitor the health of any patient placed on these drugs. If you are taking a drug to manage bipolar disorder, talk to your doctor if you notice changes in your weight or an increase in abdominal fat. Your doctor may also closely monitor your blood pressure, cholesterol levels, and blood sugar.