A recent study published in Scientific Reports provides insights into the need for integrating psychiatric care along with diabetes care to minimize metabolic problems.
The prevalence of T2DM and diabetes-related complications is increased in individuals with bipolar disorder. However, the association of bipolar disorder with hyperosmolar hyperglycemic state (HHS) and diabetic ketoacidosis (DKA) [hyperglycemia crises] remains scarce. The study aimed to determine the association between bipolar disorder and increased risk of HHS and DKA in newly diagnosed T2DM individuals.
Researchers conducted a retrospective study between 2016 and 2024, including adults diagnosed with T2DM during this period who received at least one antidiabetic medication. The study group comprised individuals with bipolar disorder diagnosed one year before the onset of T2DM, and the control group comprised those without bipolar disorder. Body mass index, comorbidities, medication use, and demographic factors were balanced using propensity score matching (1:1). The incidence of DKA and HHS was the primary outcome.
Results revealed that the risk of hyperglycemia crises increased in patients with bipolar disorder. This association was more significant in patients with cerebrovascular disease, those on insulin therapy, White individuals, and younger patients. Bipolar disorder in patients with newly diagnosed T2DM is also associated with a higher risk of acute hyperglycemia crises, suggesting the link between mental health and poor glycemic control.
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Key highlights
- There is a clear need for coordinated psychiatric and diabetes management to prevent metabolic decompensation in affected individuals.
- The link between psychiatric conditions and metabolic instability warrants further exploration to understand the underlying biological and behavioural mechanisms.
- Future research should focus on developing specific, evidence-based strategies to address this dual burden and improve patient outcomes.
Source
Liu, HJ., Lo, SC., Huang, CN. et al. Association between bipolar disorder and diabetic ketoacidosis/hyperosmolar hyperglycemic state. Sci Rep 15, 22701 (2025). https://doi.org/10.1038/s41598-025-08087-y
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Study finds bipolar disorder increases risk of diabetic emergencies like DKA and HHS in newly diagnosed T2DM patients, underscoring need for integrated psychiatric and diabetes care.
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