Bipolar Disorder and Diabetes: The Connection

About six million adults, teens and children have bipolar disorder (BD) in the US. It’s often diagnosed before the age of 25, and once it is, BD doesn’t go away. Those who live with the disease may cope with the constant shift between episodes of mania and depression.

During periods of mania, individuals become hyperactive. Their thoughts race. Their behavior can be risky. They don’t sleep, and can grow irritable. Rage can rear its head at any time.

A depressive episode can make people feel helpless, hopeless and worthless. They may not sleep — or sleep all the time. They have no energy or interest in the things they used to do.

This depression can also open the door to Type 2 diabetes. Studies show that individuals with bipolar disorder  have a two to three times higher risk of developing Type 2 diabetes than others.

Why?

Type 2 Triggers

Experts cite several reasons the risk for diabetes goes hand-in-hand with BD.

Binge eating. Bipolar depression can make people feel hungry. Food is comforting and becomes a coping mechanism — especially sugary, salty and fatty foods. Overeating is common even when BD sufferers don’t feel hungry or are uncomfortably full. Uncontrolled eating packs on pounds.

Lack of physical activity. Depression kills the desire to do many things. That includes regular exercise. Instead, BD sufferers often retreat to the comfort of their bed or sofa for long periods of time. Too little activity paired with too much food is a toxic combo that can lead to obesity.

Poor sleep. The body needs at least seven hours of sleep each night. Skimping on shut-eye doesn’t give your body time to repair itself. It also fuels hunger and boosts insulin resistance — the body’s inability to control blood sugar levels. All contribute to weight gain.

Medications. Side effects from some prescription medicines used to treat BD increase appetite. Others act like a sedative that makes people move less. Both can lead to weight gain. Still others often disturb the body’s hormonal balance and disrupt the gut’s microbiome.

The Flood-Gate Effect

Managing bipolar disorder on its own is challenging enough. Living with bipolar disorder and Type 2 diabetes is even more complex — especially when diabetes raises the risk for other life-threatening diseases such as heart disease, stroke and kidney damage.

If you are living with BD, get screened for diabetes and prediabetes regularly. Watch your blood pressure and cholesterol levels closely. If you are on BD medications and notice weight gain, talk with your care provider to see if there are other medication options.

Have a question about the connection between bipolar disease and Type 2 diabetes? Email us at BHQualityImprovement@bcbstx.com

Sources: Bipolar Disorder,  National Institute of Mental Health, 2022; Prevalence of type 2 diabetes mellitus, impaired fasting glucose, general obesity, and abdominal obesity in patients with bipolar disorder: A systematic review and meta-analysis Science Direct, Journal of Affective Disorders, 2022; How Bipolar Disorder Increases Your Risk of Developing Type 2 Diabetes, ; bpHope, 2023; Waking Up to the Importance of Sleep in Type 2 Diabetes Management, ;American Diabetes Association, 2024

Originally published 8/1/2018; Revised 2020, 2022, 2024