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Open Access Research article

Co-prescription of medication for bipolar disorder and diabetes mellitus: a nationwide population-based study with focus on gender differences

Gjertrud Svendal12*, Ole Bernt Fasmer12, Anders Engeland34, Michael Berk5678 and Anders Lund12

Author Affiliations

1 Department of Clinical Medicine, Section for Psychiatry, University of Bergen, Sandviken Hospital, Sandviksleitet 1, N-5035 Bergen, Norway

2 MoodNet Research Group, Haukeland University Hospital, Sandviken Hospital, Sandviksleitet 1, N-5035 Bergen, Norway

3 Department of Pharmacoepidemiology, Division of Epidemiology, Norwegian Institute of Public Health, PO Box 4404 Nydalen, N-0403 Oslo, Norway

4 Department of Public Health and Primary Health Care, University of Bergen, PO Box 7804, N-5020 Bergen, Norway

5 Deakin University, School of Medicine, 1 Gheringhap Street, Geelong VIC 3220, Australia

6 The University of Melbourne, Department of Psychiatry, Level 1, North Block Main Building Royal Melbourne Hospital, Parkville VIC 3050, Australia

7 Orygen Youth Health Research Centre, Centre for Youth Mental Health, 35 Poplar Road, Parkville VIC 3052, Australia

8 Florey Institute of Neuroscience and Mental Health, Level 3, Alan Gilbert Building, 161 Barry Street, University of Melbourne, Parkville VIC 3010,, Australia

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BMC Medicine 2012, 10:148  doi:10.1186/1741-7015-10-148

Published: 27 November 2012

Abstract

Background

Studies have shown a correlation between bipolar disorder and diabetes mellitus. It is unclear if this correlation is a part of common pathophysiological pathways, or if medication for bipolar disorder has negative effects on blood sugar regulation.

Methods

The Norwegian prescription database was analyzed. Prescriptions for lithium, lamotrigine, carbamazepine and valproate were used as proxies for bipolar disorder. Prescriptions for insulin and oral anti-diabetic agents were used as proxies for diabetes mellitus. We explored the association between medication for bipolar disorder and diabetes medication by logistic regression

Results

We found a strong association between concomitant use of medication to treat diabetes mellitus and mood stabilizers for the treatment of bipolar disorder. Females had a 30% higher risk compared to men of being treated for both disorders. Persons using oral anti-diabetic agents had higher odds of receiving valproate than either lithium or lamotrigine. Use of insulin as monotherapy seemed to have lower odds than oral anti-diabetic agents of co-prescription of mood stabilizers, compared to the general population.

Conclusions

This study showed a strong association between the use of mood stabilizers and anti-diabetic agents. The association was stronger among women than men.