BMI independently relates to glycaemia in patients with severe enduring mental illness (SMI).
BACKGROUND
People with severe mental illness (SMI) have higher rates of diabetes than the general population.


OBJECTIVE
To assess the type-2 diabetes screening rates in primary care and the relation between body mass index (BMI) and dysglycaemia for patients on the SMI register in the Cheshire region of the United Kingdom.


METHODS
The setting was 24 general practices in Central and Eastern Cheshire, United Kingdom. Subjects were identified through a semianonymized search of GP registers.


RESULTS
About 451 of the 787 SMI patients were screened for dysglycaemia and dyslipidaemia. Fasting glucose was in the impaired fasting glycaemia range (6.1-6.9 mmol/l) in 6.5%, and indicative of type-2 diabetes (≥7.0 mmol/l) in 17.3%. There was a positive univariate relation between BMI and fasting glucose (normalized β = 0.26, p < 0.001). In multivariate models, adjusting for age, gender, smoking and blood pressure, each unit increase in BMI [OR = 1.07 (1.01, 1.13); p = 0.031] and triglycerides [OR = 1.28 (1.06, 1.55); p = 0.009] were independently associated with an increased risk of having type-2 diabetes.


CONCLUSIONS
Increasing BMI relates to dysglycaemia in patients with severe enduring mental illness (SMI). All patients with SMI whether or not receiving neuroleptic treatment should undergo routine monitoring of weight and metabolic parameters.
a Cardiovascular Sciences Research Group and Manchester Academic Health Science Centre, The University of Manchester , Manchester , United Kingdom.
Simon G
SG
Anderson
b Department of Obesity and Endocrinology , University of Liverpool , Liverpool , United Kingdom.
Ram P
RP
Narayanan
c Department of Medicine , Leighton Hospital , Crewe , United Kingdom.
Daniela
D
Radford
d Bradwell Hospital Site, Staffordshire and Stoke-on-Trent Partnership NHS Trust , Newcastle-under-Lyme , United Kingdom.
Richard
R
Hodgson
e University Psychiatric Center, Katholieke Universiteit Leuven , Campus Kortenberg, Leuvensesteenweg, Kortenberg , Belgium.
Marc
M
De Hert
f Institute of Population Health, University of Manchester , Manchester , United Kingdom.
Adrian H
AH
Heald
D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D050171:Dyslipidemias / Q000097:blood; D005260:Female; D038321:Glycemic Index; D006801:Humans; D008297:Male; D008403:Mass Screening; D001523:Mental Disorders / Q000097:blood* / Q000150:complications; D008875:Middle Aged; D012307:Risk Factors
D001786:Blood Glucose
Severe enduring mental illness (SMI); body mass index (BMI); diabetes; dyslipidaemia; glucose intolerance; primary care