Researchers identify molecular link between schizophrenia and diabetes risk

That is the title of this article I am writing about. " It has long been known that psychiatric disorders, such as schizophrenia, have been associated with a higher risk of type 2 diabetes. In a new study published online in The FASEB Journal, a UMass Medical School research team, led by Rita Bortell, PhD, research professor of molecular medicine and Agata Jurczyk, PhD, instructor in molecular medicine, found that a shared gene (or genes) may underlie the co-occurrence of both diseases. Mutations in Disrupted in Schizophrenia 1 (DISC1) have been strongly associated with major psychiatric disorders, including schizophrenia, but not diabetes. This study presented the first evidence to indicate that the DISC1 gene also plays a novel, unexpected role in pancreatic beta cell survival and function. It is also the first to provide a molecular link for a prevalence of type 2 diabetes in individuals with psychiatric disorders.  To make this discovery, Dr. Bortell and her team genetically manipulated a group of mice to disrupt the DISC1 gene only in the mouse's pancreatic beta cells, not in the brain. The mice with the disrupted DISC1 gene showed an increase in beta cell death, less insulin secretion and impaired glucose regulation compared to normal mice. When these researchers studied cultured beta cells in which DISC1 expression was suppressed, they found that DISC1 works by inhibiting the activity of a specific protein, GSK3β. Lowered GSK3β activity was already known to be critical for beta cell function and survival. The research team further tested the validity of this association by inhibiting GSK3β function directly. This resulted in improved beta cell survival and restored normal glucose tolerance in mice with disrupted DISC1. These results uncover an unexpected role for DISC1 in normal beta cell physiology and suggest that DISC1 may regulate blood glucose independently of its function in the brain." More reasons for me to work harder so it does not come back.  I will do anything not to have to take that pill for diabetes.
The article goes on to say: "'It is known that individuals with psychiatric disorders may be predisposed to developing type 2 diabetes due to several interacting factors including genetics, lifestyle and medications. Based on our mouse studies, our data predict that DISC1 disruption could tip the balance toward disease," Bortell said, adding that it remains to be demonstrated in humans. "Our hope is that the association we've found linking disrupted DISC1 to both diabetes and psychiatric disorders may uncover mechanisms to improve therapies to alleviate suffering caused by both illnesses, which are extraordinarily costly, very common and quite debilitating.'"I hope they can soon find an answer to both diseases. It reeks havoc on the body with diabetes.
The article ends: "Bortell said the study points out the potential importance of evaluating new antipsychotic medications for their effects on pancreatic beta cells in addition to the brain. Diligent monitoring for diabetes in those with Psychiatric disorders is further warranted by the fact that many antipsychotic medications are also associated with an increased risk of diabetes. "We are also intrigued by the fact that diabetic individuals have higher rates of depression, which suggests that additional molecular links in brain and pancreatic beta cells may yet be discovered," Bortell said.
The full study can be found online in The FASEB Journal and will be published in print in February." The medications causes diabetes we are more susceptible to diabetes. How can we win you just have to keep fighting for what you believe you want for your life.

Those with Severe Mental Illness Rarely Tested for Diabetes Despite High Risk

That is the title of this article I am writing about. "Despite the fact that individuals with severe mental illness (SMI) are two to three times more likely to have type II diabetes than the general population, low-income patients on Medicaid are rarely screened for it, according to a new study led by the University of California, San Francisco (UCSF).  The findings support growing efforts to integrate mental health services with primary care to improve diagnosis and treatment of health issues associated with mental illness, the researchers said.  Although many factors contribute to the increased risk, treatment with antipsychotic medication raises the risk for diabetes even further. The American Diabetes Association and American Psychiatric Association both recommend that physicians conduct annual diabetes screening for any patients taking antipsychotic medications, but until now it has been unclear how often screenings actually occur.  For the study, researchers examined diabetes screenings in a group of 50,915 publicly insured adults with SMI who were on antipsychotic medication. The findings showed that over 70 percent of these patients did not receive a diabetes-specific test. However, those who had at least one primary care visit in addition to mental health services were twice as likely to be screened.  Our health care system is fragmented for people with mental illness. For example, the mental health electronic medical record is totally separate from their primary care electronic record, truly limiting the quality of care this vulnerable population can receive,' said Christina Mangurian, M.D., M.A.S., associate professor of clinical psychiatry at the UCSF School of Medicine and lead author of the study."I have labs done every three months. I diet controlled diabetes.  My doctor said because of the antipsychotic medicine I have to work harder to control that it does not come back. I walk and watch the corn fructose syrup that is a bad one I try and stay away. I do not like the taste of diet pop either.
The article goes on to say: "As a community psychiatrist, I see so many people who are untreated or under-treated for physical health problems because of this lack of integration.'  'Many of these patients are dying of premature cardiovascular disease,' said Mangurian. 'They tend to smoke cigarettes, hardly exercise, and may deal with food insecurity as a result of financial problems.'
Even further, their antipsychotic medication disrupts metabolic function, causing them to gain weight rapidly, which can lead to insulin resistance and diabetes.  The study is the first to examine diabetes screening in this high-risk population served in community mental health clinics. In an effort to integrate primary care and mental health, the California Department of Health Services’ Data and Research Committee combined public mental health and medical records during a State Quality Improvement project. This allowed the researchers to compare individuals across the two datasets.
The findings showed that about 30 percent of the patients with severe mental illness received a diabetes-specific screening and about 30 percent received no medical tests at all. Patients who had at least one primary care visit were more than twice as likely to be screened for diabetes as those who did not.  Integrated health care would make it easier for patients to get screening and treatment, said study co-author Penelope Knapp, M.D., professor of psychiatry and behavioral sciences at University of California, Davis." I hope people with mental illness take this serious because it is.  Last week I told people in the blog that I was worried because of my lungs. I still am worried but I thought about it last night whatever is wrong I will beat it I have overcome so much in my life. I will overcome this also. Like I always say those grand kids need me and I need them.
The article ends: "'We can do better,' Knapp said. 'It’s really important for individuals with medical and mental health problems to have their health care in one system. It’s a no-brainer that these should be integrated.'  There are many factors that could explain why the majority of SMI patients in this study were never screened for diabetes, Knapp said. The study examined people with Medicaid, a program that provides health and medical services for low-income individuals and families.
'One of the barriers for not-so-wealthy people is that they can’t see two providers on the same day. If the psychiatrist prescribes antipsychotics, that person may not be able to take off work another day for a followup appointment with a physician,' Knapp said.  An integrated health care system would allow mental health and medical records to 'talk' to each other, an essential asset for patients with mental illness. If the physician could access mental health records, they could see the diagnosis and prescription and immediately understand the risk of diabetes, Mangurian said. This is especially important for young patients.  “The young adults who develop a psychotic illness in college or high school — they are the ones I’m worried about,” Mangurian said.  “Diabetes in a young adult is not on a primary care doctor’s radar. These doctors need to learn that if their patient has a diagnosis of schizophrenia or is taking an antipsychotic medication, they are at increased risk.” I let my doctor know that I am taking antipyschotic medicine and that I have paranoid schizophrenia.  It is important that you share everything if you want to get treated in the right way. You don't want something that will cause a reaction with your other medicines.

Adults with Schizophrenia at Greater Risk of Premature Death

That is the title of this article I am writing about. "Adults with schizophrenia are 3.5 times more likely to die prematurely, particularly from cardiovascular and respiratory diseases, compared to the average population, according to a new study published online by JAMA Psychiatry.  Many factors contribute to the risk of premature death, including economic disadvantage, negative health behaviors, and difficulty accessing and adhering to medical treatments. Specifically, the following harmful traits are more common in those with schizophrenia than in the general population: smoking, limited physical activity, obesity, elevated blood glucose level, hypertension, and dyslipidemia (abnormal amount of lipids, such as fat or cholesterol, in the blood)."I wonder is it the antipsychotic drugs we take that could cause respiratory diseases. I wonder because I am going through something with my lungs right now.  About a month ago I was diagnosed with walking pneumonia.  Now I have to go see a  lung specialist because it has not left my lungs. I do not smoke and have not smoked in seventeen years.
The article goes on to say: "Among the 65,553 deaths with a known cause, 55,741 were from natural causes, which include a variety of diseases, and 9,812 were due to unnatural deaths, which included suicide, homicide assault, and accidents, both poisoning and non-poisoning, according to the results.
Cardiovascular disease had the highest mortality rate and accounted for almost one-third of all natural deaths. Cancer accounted for about one in six deaths. Among the other natural causes of death, chronic obstructive pulmonary disease (COPD), diabetes, influenza, and pneumonia had the highest mortality rates.  Unnatural causes of death accounted for about one in seven deaths with known causes, with suicide accounting for about one-quarter of the unnatural deaths. Accidents accounted for more than twice as many deaths as suicide."This is disturbing news for me. I do not want to go back on disability.  I hope I have good news tomorrow at the lung doctor.
The article ends with: "Nonsuicidal substance-induced death, mostly from alcohol or other drugs, also was a leading cause of death.  Limitations noted by the authors include not having information about key health risk factors such as smoking status, body mass index, and substance abuse.

“The results from this study confirm a marked excess of deaths in schizophrenia, particularly from cardiovascular and respiratory disease, that is evident in early adulthood and persists into later life,” writes Mark Olfson, M.D., M.P.H., of Columbia University, New York, and coauthors.
'Especially high risks of mortality were observed from diseases for which tobacco use is a key risk factor. These findings support efforts to train mental health care professionals in tobacco use prevention and treatment and in implementation of policies that incentivize smoking control interventions in settings treating patients with schizophrenia.'"That would make me give up smoking if I still smoked this is serious business. Like I have said before I have grand kids I want to see grow up.

Initial Psychotic Episode Best Managed by Team-Based Approach

That is the title of this article I am writing about. "A new project funded by the National Institute of Mental Health (NIMH) suggests that first episode psychosis is best cared for using a team-based, coordinated specialty care approach.  This strategy was found to produce better clinical and functional outcomes than typical community care. Investigators also found treatment is most effective when provided soon after psychotic symptoms begin.  John M. Kane, M.D. is the leader of the RAISE Early Treatment Program, one of two studies that make up the Recovery After an Initial Schizophrenia Episode (RAISE) project. The team’s research is published online in The American Journal of Psychiatry.  Kane and his colleagues trained clinical staff at real-world clinics around the country to use a coordinated specialty care treatment program called NAVIGATE. The program featured a team of specialists who worked with each client to create a personalized treatment plan."I did not get help until my second episode.  If I would have recieved help the first time it would have saved me a lot of time. I do not know if I was ready to start and education at that time although I would have come around to it.
The article goes on to say: "The treatment approach was based on shared decision making between the client and team. In addition, the treatment involved family members as much as possible.
'The goal is to link someone experiencing first episode psychosis with a coordinated specialty care team as soon as possible after psychotic symptoms begin,' said Kane.  'Our study shows that this kind of treatment can be implemented in clinics around the country. It improves outcomes and the effects are greater for those with a shorter duration of untreated psychosis.'  For the study, 404 individuals with first episode psychosis enrolled in the program (223 at clinics using the NAVIGATE coordinated specialty care program and 181 at clinics using ‘typical-care’).  Patients treated at clinics using the NAVIGATE program remained in treatment longer, and experienced greater improvement in their symptoms, interpersonal relationships, quality of life, and involvement in work and school compared with patients at the typical-care sites.  Obtaining care in a timely manner was extremely important. The Kane team found that the amount of time between the beginning of psychotic symptoms and the beginning of treatment (called the duration of untreated psychosis or DUP) strongly influenced treatment outcomes."While with this program maybe I would have started college earlier.  If only the doctor that had treated me thought it was something else besides sleep depredation.
The article ends with: Half of study participants had a DUP under 74 weeks and half had longer periods of untreated psychosis. NAVIGATE patients with a DUP of less than 74 weeks had much greater improvement in quality of life and overall symptoms compared with those with a longer DUP and those in community care.  'Clearly, the take-home message here is that outcomes for young people with early psychosis are better when clinicians do the right things at the right time,' said Robert Heinssen, Ph.D., director of the Division of Services and Intervention Research at NIMH.

'Dr. Kane’s work is having an immediate impact on clinical practice in the U.S. and is setting a new standard of care.  We’re seeing more states adopt coordinated specialty care programs for first episode psychosis, offering hope to thousands of clients and family members who deserve the best care that science can deliver.'"It would help a lot get jobs and lead a decent life.  I know that some people now would give anything to be able to work or go to school.  I do not know which change me more from always being locked up.  The illness or the place I hate more than anything the state hospital.  I went through so many change reverse psychology used on me. I never want to be locked up in that place again if i was ever locked I will not use the insane clause. I'd rather go to prison.