I see a number of patients who have been on valproic acid for months or years, many with significantly increased triglyceride levels. One of them died without an elevated amylase. It is unlikely that bipolar patients would be on many other medications other than valproate. It is more likely that patients with epilepsy are referred to here. Although some extrapolation can be made to bipolar disorder, the efficacy and adverse effects of valproate differ in many ways for bipolar disorder compared to epilepsy.
Epilepsy is likely to be treated with more medications and higher doses than is bipolar disorder.
Regarding the increased triglycerides and glucose, these are not characteristic adverse effects of valproate. In our recently completed one year study of valproate in bipolar disorder there was no increase in triglycerides or glucose associated with valproate.