Current Projects

Screening

Identifying the prevalence of diabetes and pre-diabetes, and risk factors for diabetes in schizophrenia through opportunistic screening along with routine clinical care. Over 1000 people receiving treatment for schizophrenia and schizo-affective disorder have been screened, and the results are being analyzed and prepared for publication.

Intervention

Developing educational, preventive and treatment strategies suitable for mentally ill population, and establishing their effectiveness through systematic evaluation. The package of custom-built interventions (Going beyond, Healthy living and People in Motion) is used as the modified diabetes prevention protocol, and is being compared against standard clinical interventions, metformin and placebo. People who are identified as having pre-diabetes on the initial screening are randomized to one of the four intervention groups, receive the intervention for a year, and are monitored clinically and biochemically for a period of three years. Outcome measures include changes in weight, blood sugar levels and the number of cases of new-onset diabetes in each of the treatment groups.

Health care delivery

Examining the barriers to care, i.e., intra-personal, inter-personal, environmental and systemic issues, and modify individual life styles, professional practice patterns and health services organization. It has been noted that people with both diabetes and mental illness have unique needs, and conventional interventions centred on diabetes self education and management are ineffective in these populations.

Population health

It has been known that aboriginal populations in general, have an increased risk of diabetes; and aboriginal people treated for schizophrenia carry even a greater risk for this disorder. Preparations are underway to start metabolic screening in two aboriginal communities, assess their specific needs and barriers to care, and develop appropriate preventive interventions.

Basic sciences

This involves exploring the metabolic and neurobiological mechanisms underlying the occurrence of diabetes in schizophrenia.