Optimization of early diagnosis of glucose metabolism impairment for patients receiving antipsychotic medications at outpatient psychiatric clinic of the university teaching hospital.

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Pandu, Makame Haji
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The University of Zambia
Patients using antipsychotic drugs are more likely than the general population to suffer glucose metabolism dysfunctions, yet these problems are frequently overlooked. According to several research findings, patients who take antipsychotic drugs, particularly second-generation antipsychotics, are four times more likely to develop overweight, obesity, and diabetes type 2. Furthermore, studies have indicated that failing to recognize these metabolic issues puts an individual at risk of getting comorbid disorders such as cardio-metabolic diseases and others which potentially worsen psychiatric problems. For controlling and enhancing potential psychiatric treatment outcomes, early diagnosis and treatment of glucose metabolism dysfunction is crucial. Between June and September 2021, a descriptive cross-sectional study was conducted at the University Teaching Hospital outpatient psychiatric clinic to optimize the early diagnosis of glucose metabolism deficits in patients with psychiatric disorders taking antipsychotic medications. A systematic sampling method was applied to all patients who were receiving antipsychotic drugs. All participants were checked for their weight, height, Body Mass Index (BMI), waist circumference, random and fasting blood glucose levels, respectively. The results were analyzed by using SPSS software versions 20, while Fisher’s exact test was used to determine the relationship between categorical variables. A total of ninety patients with psychotic disorders aged 18 years and above were recruited for the study; 47.8% were male and 52.2% were female. 26.7% were overweight (BMI 24.5-29.5kg/m2), 14.4% were obese (BMI>30kg/m2) and 11.1% were under weight (BMI <18.5kg/m2), and 38.9% had higher waist circumferences. The proportion of individuals with impaired fasting blood glucose levels found in this study was 11.1% and that of individuals with diabetes was 10.0%, respectively which is higher compared to the general population. Patients who were receiving second-generation antipsychotics showed a slightly higher proportion of impaired fasting blood glucose levels compared to those on conventional antipsychotic medications. Increased waist circumference and increased age were significant factors associated with impaired glucose metabolism. It is, therefore, recommended that screening of glucose metabolic parameters should be a routine practice by psychiatrists and other health professionals working in psychiatric clinics before treatment with antipsychotic medications is started; there should be a regular follow up and monitoring of glucose metabolic parameters for all patients who are on treatment with antipsychotic medications. Education on a healthy lifestyle should also be disseminated in every visit, multidisciplinary approach involving other specialists input like physician and endocrinologist should always be applied to all patients who are diagnosed with glucose metabolism impairments.
Thesis of Master of Medicine in Psychiatry.