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The British Journal of Psychiatry (2004) 184: s55-S63
© 2004 The Royal College of Psychiatrists

Diagnosis, epidemiology and pathogenesis of diabetes mellitus: an update for psychiatrists

Richard I. G. Holt, MA MB BChir PhD MRCP(UK)

Endocrinology and Metabolism Sub-Division, Fetal Origins of Adult Disease Division, University of Southampton, Level F (MP113) Centre Block, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK.

Correspondence: Tel: (0) 23 8079 4665; fax: (0) 23 8079 4154; e-mail: righ{at}soton.ac.uk

Declaration of interest R.I.G.H. has received educational grants and fees for lecturing and consultancy work from Eli Lilly & Co.

Background Diabetes mellitus is a complex metabolic disorder characterised by persistent hyperglycaemia. The prevalence of diabetes is increased in people with schizophrenia.

Aims To provide an update of current thinking in diabetes for practising psychiatrists.

Method Literature review.

Results Diabetes is a costly condition in individual, social and economic terms, and the global burden of diabetes is increasing in most populations. The insidious onset and asymptomatic nature of diabetes results in many people remaining undiagnosed and at great risk of developing life-threatening vascular complications. Lifestyle and pharmacological interventions can reduce incident diabetes and delay its progression.

Conclusions Public health policies are urgently required to encourage people to follow a healthy lifestyle. Primary prevention strategies for diabetes should target individuals at especially high risk of developing type 2 diabetes, including those with severe mental illness.




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Introduction
The British Journal of Psychiatry, April 1, 2004; 184(47): s53 - s54.
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