People living with schizophrenia—a chronic mental disorder characterized by hallucinations, delusions and cognitive issues—are three times more likely than the general population to develop type 2 diabetes. While the effects of antipsychotic treatments and various lifestyle behaviors play a role in this increased risk, new findings published in JAMA Psychiatry suggest there may also be a direct link between the disabling mental illness and the metabolic disorder, Science Daily reports.

Type 2 diabetes occurs when the body doesn’t produce enough of the hormone insulin to regulate blood sugar properly. The metabolic condition is a major risk factor for heart attack and stroke, both of which past medical studies have linked to schizophrenia. But until now, medical experts had not made a direct link between diabetes and the mental illness.

For this latest study, researchers at King’s College London compiled data from 16 studies comprising 731 individuals who suffered a first episode of schizophrenia and were not yet on treatment. Scientists compared this group with 614 people from the general population. After researchers reviewed blood tests from these studies, they found that patients with schizophrenia showed higher levels of fasting blood glucose, a clinical indicator of diabetes risk.

In addition, findings showed that compared with their healthy controls, individuals with early-onset schizophrenia exhibited higher levels of insulin and insulin resistance. What’s more, these results remained significant even when the dietary intake, exercise levels and ethnic backgrounds of patients and controls matched.

“These findings are a wake-up call that we need to rethink the link between diabetes and schizophrenia and start prevention right from the onset of schizophrenia,” said Oliver Howes, PhD, a professor at the Institute of Psychiatry, Psychology & Neuroscience at King’s College London and the study’s senior author.

Researchers noted that because certain antipsychotics may further increase the risk of diabetes, clinicians were also obligated to prescribe suitable meds at appropriate dosages. Additionally, study authors highlighted several possibilities that could boost the chance that folks might develop both conditions, such as premature birth, low birth weight and a rise in levels of the stress hormone cortisol that’s associated with the onset of schizophrenia.

Did you know that daily exercise could help treat symptoms of schizophrenia? Click here to learn more.