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Comment & Response
July 2017

First-Episode Schizophrenia and Diabetes Risk—Reply

Author Affiliations
  • 1Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, England
  • 2South London and Maudsley NHS Foundation Trust, London, England
  • 3MRC London Institute of Medical Sciences, Hammersmith Hospital, London, England
  • 4Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, England
JAMA Psychiatry. 2017;74(7):763. doi:10.1001/jamapsychiatry.2017.0765

In Reply We thank Bortolasci, Mangurian, and Cui and their respective colleagues for their comments on our article.1 Both type 2 diabetes and schizophrenia have complex pathoetiologies with genetic and environmental roots, and their letters reflect this.

We agree with Bortolasci and colleagues that mitochondrial dysfunction is a potential mechanism underlying the association between schizophrenia and glucose dysregulation. Regardless of mechanism, the findings of our meta-analysis are a reminder to clinicians that altered glucose regulation should be considered from the first psychotic episode. Large prospective longitudinal studies are required to define the role of modifiable factors.