It might not seem like an obvious connection, but people living with mood disorders are at risk of type 2 diabetes. Because of this, yearly screening is done for insulin resistance in bipolar patients - thanks to the research of a QEII psychiatrist.

Psychiatrist Dr. Cindy Calkin treats patients who live with bipolar disorder at QEII Health Sciences Centre's Mood Disorder Clinic. When she noticed some patients weren't getting better she wanted to know why.

"There seemed to be something else that was probably going on,” says Dr. Calkin. “I had this feeling that is was something sort of right in front of me, but it just hadn't yet been sort of figured out."

After doing research, it became clear obese bipolar patients tended to be sicker.

Obesity is a risk factor for insulin resistance - a pre-diabetic state on the way to type 2 diabetes.

Dr. Calkin found 32 per cent of bipolar patients have insulin resistance, 22 per cent have type 2 diabetes - which is almost three times the rate of the general population.

"If you have bipolar disorder and insulin resistance, or type 2 diabetes, you're three times more likely to have a chronic course of illness, or rapid cycling, which is a very difficult form of bipolar disorder to treat,” says Dr. Calkin. “And you're eight and a half times more likely not to respond to mood stabilizing treatment."

This research led to a recommendation of yearly screenings for insulin resistance in bipolar disorder patients.

Then, in 2013 the QEII’s Mood and Metabolism program was born.

"We realized that we needed to follow people long-term and to see what happened and also to monitor these factors," says Dr. Calkin.

Endocrinologist Dr. Tom Ransom works alongside Dr. Calkin in the multidisciplinary program. He deals with the metabolic side of things.

"I pay more attention to the blood pressure, the cholesterol, diabetes/insulin resistance - those sorts of things - so that's my half of the equation," says Dr. Ransom.

Dr. Ransom helps manage those risk factors - treating patients with both lifestyle and pharmacological approaches. He says one of the main strengths of the program is that it treats bipolar and metabolic issues at the same time.

"People used to take mood and psychiatric issues and have them separate from the metabolic medicine - say two entities - and I don't know if we're bringing them together, or if they were inappropriately apart before, but nonetheless we know that there's a significant interplay between them."

The result is better patient care.

"The patients are appreciative of the attention they're getting. These other issues are being addressed and they're not just sort of being categorized as someone with a mood disorder and other issues - that it's all together and we're sort of completing the picture for them,” says Dr. Ransom.

If you'd like more information - or to join the Mood and Metabolism registry - you can call: 902 473 8040.