4.13.5.0 Se­ri­ous Men­tal Ill­ness

Rec­om­men­da­tions

4.25 An­nu­ally screen peo­ple who are pre­scribed atyp­i­cal an­tipsy­chot­ic med­i­ca­tions for predi­a­betes or di­a­betes. B

4.26 If a sec­ond-‍gen­er­a­tion an­tipsy­chot­ic med­i­ca­tion is pre­scribed for ado­les­cents or adults with di­a­betes, changes in weight, glycemic con­trol, and choles­terol lev­els should be care­ful­ly mon­i­tored and the treat­ment reg­i­men should be reas­sessed. C

4.27 In­cor­po­rate mon­i­tor­ing of di­a­betes self-‍care ac­tiv­i­ties into treat­ment goals in peo­ple with di­a­betes and se­ri­ous men­tal ill­ness. B

Stud­ies of in­di­vid­u­als with se­ri­ous men­tal ill­ness, par­tic­u­lar­ly schizophre­nia and other thought disor­ders, show significant­ly in­creased rates of type 2 di­a­betes (112). Peo­ple with schizophre­nia should bemon­i­tored for type 2 di­a­betes be­cause of the known co­mor­bidity. Dis­or­dered think­ing and judg­ment can be ex­pect­ed to make it difficult to en­gage in be­hav­iors that re­duce risk fac­tors for type 2 di­a­betes, such as re­strained eat­ing for weight man­age­ment. Co­or­di­nat­ed man­age­ment of di­a­betes or predi­a­betes and se­ri­ous men­tal ill­ness is rec­om­mend­ed to achieve di­a­betes treat­ment tar­gets. In ad­di­tion, those tak­ing sec­ond-‍gen­er­a­tion (atyp­i­cal) an­tipsy­chot­ics, such as olan­za­p­ine, re­quire greater mon­i­tor­ing be­cause of an in­crease in risk of type 2 di­a­betes as­so­ci­at­ed with this med­i­ca­tion (113).