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  • Five years ago I was diagnosed with Type II Diabetes. Immediately thereafter, I changed my lifestyle and my blood sugar levels, both fasting and A1C, returned to normal levels. I was a stable diabetic until November, 2004. In November, 2004 I was diagnosed with bipolar disorder and was prescribed 1500 mg of Lithium per day. In December, 2004 my blood sugar levels, both fasting and A1C, started to creep up. By December, 2005 they were very high. I am now trying very hard to bring them down again by diet and exercise. It is much harder this time. I am also taking 1000 mg of Metformin a day. My question is whether the Lithium could be partially responsible for the high blood sugar levels. I have read that Lithium can cause something called Diabetes Insipidus - but I do not believe I have that. My family doctor and endocrynologist do not believe there is a connection. I can't believe it is a coincidence that my sugars started rising when I went on Lithium. Thanks.


  • salisbury5... I worked in the field of mental health for 25+ years, and it's commonly known that lithium contributes significantly to the likelihood of weight gain. Elevated body weight itself is a risk factor for Type II Diabetes, especially with regard to body-mass index (BMI) measurement higher than 27. Age, an apple-shaped figure, increased blood pressure, and higher cholesterol levels are additional, related risk factors. See this page about diabetes on the Public Health Agency of Canada website: http://www.phac-aspc.gc.ca/ccdpc-cpcmc/diabetes-diabete/english/risk/index.html In controlled scientific studies, such as this one, summarized in an abstract on the PubMed website, by Vestergaard P, Schou M., states definitively: "Fasting blood sugar was determined in manic-depressive patients before the start of lithium treatment and at intervals during treatment for up to 6 years. The total exposure time to lithium was 495.5 years. Even though the patients gained significantly in age and body weight during the treatment, their mean blood sugar values remained the same as before treatment was started, and only 1 patient developed manifest diabetes. There is no reason to believe that long-term lithium treatment leads to increased risk of developing diabetes mellitus." http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3683801&dopt=Abstract While you haven't noted your age, or whether your current weight is higher than it was when you began treatment with lithium, my experience tells me that you have likely gained some weight, and this, along with your advancing age, is enough to contribute to a return of the symptoms of the Type II Diabetes with which you were previously diagnosed. If the lithium has been effective in treating the bipolar disorder, it's also likely that you are somewhat less physically active than previously, and this would be yet another contributing factor. There are, nonetheless, several sources which indicate that lithium is one of many factors which could result in higher measurements during testing, such as this one from the LabTestsOnline website: "Some of the other diseases and conditions that can result in elevated glucose levels include: - Acromegaly - Acute stress (response to trauma, heart attack, and stroke for instance) - Chronic renal failure - Cushing syndrome - Drugs, including: corticosteroids, tricyclic antidepressants, diuretics, epinephrine, estrogens (birth control pills and hormone replacement), lithium, phenytoin (Dilantin), salicylates, - Excessive food intake - Hyperthyroidism - Pancreatic cancer - Pancreatitis" http://www.labtestsonline.org/understanding/analytes/glucose/test.html Note that the study cited above stated that "their MEAN blood sugar values remained the same as before treatment was started". So, if I were you, I would expect the occasional test to turn up an elevated level due to the lithium, but if the levels are consistently high, I would look to the other factors such as weight gain, lack of exercise, increasing waistline, advancing age, and elevated blood pressure cholesterol levels. You could also explore, with your doctor, alternate medications which might cause less weight gain. Since you never mentioned weight gain or your age or any of the other factors, I could be completely off here. If that's the case, please feel free to elaborate on your specifics. Please do not rate this answer until you are satisfied that the answer cannot be improved upon by way of a dialog established through the "Request for Clarification" process. A user's guide on this topic is on skermit-ga's site, here: http://www.christopherwu.net/google_answers/answer_guide.html#how_clarify sublime1-ga Additional information may be found from an exploration of the links resulting from the Google searches outlined below. Searches done, via Google: lithium "blood sugar" ://www.google.com/search?q=lithium+%22blood+sugar%22 diabetes "risk factors" ://www.google.com/search?q=diabetes+%22risk+factors%22 "fasting glucose" lithium ://www.google.com/search?q=%22fasting+glucose%22+lithium "bipolar disorder" medication "causes less weight gain" ://www.google.com/search?q=%22bipolar+disorder%22+medication+%22causes+less+weight+gain


  • Thank you very much. I appreciate your thoughtful and thorough answer. I was first diagnosed at age 35. I am now 39. Due to the bipolar illness, I lost about 15 pounds from September, 2004 to November, 2004. I regained all that weight back, returning to my normal weight, by about March, 2005. My weight has remained more or less level since then, which is about 20 pounds overweight. I guess the weight loss, coupled by the weight gain, may have started the diabetes ball rolling again. It just sure seems coincidental that I also started lithium at that time. Any comments before we put this to bed? Time to go evercise...


  • salisbury5... The details you've provided tend to confirm what I suspected, so there's not much I'd add. 20 pounds overweight, in itself, is not necessarily bad, but I'd recommend you calculate your body mass index using the following calculator, and entering your height, weight, age and gender: http://www.halls.md/ideal-weight/body.htm This page also shows the average weight that others of your age have specified as ideal, as well as the recommendation of the medical field. The following page presents a BMI calculator which uses either the halls.md v2 method or the WHO & CDC criteria: to arrive at a 'body description' of your weight: http://www.halls.md/body-mass-index/bmi.htm Dr Hall's criteria result in the chart on this page: http://www.halls.md/body-mass-index/bmirefs.htm The difference between the two sets of criteria is discussed on the following two pages: http://www.halls.md/body-mass-index/overweight.htm http://www.halls.md/body-mass-index/age.htm Happy exercising! sublime1-ga







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