Bipolar Disorder and Diabetes - What's the Connection?

Diabetes and bipolar disorder are co-morbid conditions. This means they often coexist, with many people having both bipolar disorder and diabetes.

Research indicates that this is more than an unfortunate coincidence. Some studies have shown people with bipolar disorder are up to three times more likely to have diabetes than members of the general population.

Also, there is evidence that people with bipolar disorder and diabetes are more likely to face other health challenges such as being more prone to rapid cycling, and more likely to have chronic, as opposed to milder, mood episodes. There may be other negative lifestyle consequences as well. One Canadian study found that 81% of bipolar people with diabetes were receiving disability payments, versus 30% of bipolar patients without diabetes.

In diabetes, because of either a shortage of insulin, or an inability by the body to make use of insulin, sugar and other food can no longer be correctly metabolized and turned into energy. Sugar simply continues to accumulate in the blood, causing a variety of health problems.

The diabetic mood swings resulting from excess sugar and carbohydrates in the body are extremely similar to the mood swings experienced in bipolar disorder. A person with diabetes may seem depressed, or manic, or both.

There is also pre-diabetes, some experts consider America's largest healthcare epidemic. Also known as Syndrome X or metabolic syndrome, this condition occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of Type 2 diabetes. As of 2009 there are 57 million Americans who have pre-diabetes.

To make matters worse, several of the leading medications used to treat bipolar disorder can cause significant weight gain, insulin resistance, and hyperglycemia.

Diabetes is usually treated by changes in diet and through medication, for example regular injections of insulin.

The most important dietary changes are to opt for foods high in nutrition but low in calories, sugar and fat. As stabilizing blood sugar is so important, it is ideal if you can eat your meals at the same time every day, and consume a healthy proportion of carbohydrates, proteins and fats, with little variation to the ratio from day to day.

Increased physical activity such as the kind of exercise program that also protects against mood swings and depression is also important in both treating and preventing metabolic syndrome and Type 2 diabetes.

Why do diabetes and bipolar co-occur? This question has yet to be answered definitively. However, there are several theories, including the following:

• The stress hormone cortisol tends to be elevated in both bipolar patients and diabetics. In particular, very high level levels of cortisol have been observed in people suffering from bipolar depression. Too much cortisol leads to insulin resistance so it is possible that the elevated cortisol in people with bipolar disorder leads to diabetes.
• People with bipolar disorder often self-medicate with food, including the "comfort foods" high in sugar and saturated fats that contribute to both metabolic syndrome and Type 2 diabetes. All people diagnosed with bipolar disorder should immediately have a comprehensive physical exam to check for the presence of common co-morbid conditions, especially diabetes.

All people diagnosed with bipolar disorder should immediately have a comprehensive physical exam to check for the presence of common co-morbid conditions, especially diabetes.

Sarah Freeman is an attorney with manic-depressive illness, author of the best-selling e-Book The Bipolar Diet, and webmaster of Bipolar-Lives.com - one of the Internet's leading sites on bipolar disorder.

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