Weighing In: Emergent Diabetes Mellitus and Second-Generation Antipsychotics

2007 ◽  
Vol 41 (10) ◽  
pp. 1725-1727 ◽  
Author(s):  
Robert L Dufresne
Keyword(s):  
Diabetes Mellitus ◽  
Second Generation ◽  
Epidemiologic Studies ◽  
Metabolic Effects ◽  
Antipsychotic Treatment ◽  
Background Rate ◽  
High Background ◽  
Second Generation Antipsychotics ◽  
Glucose Dysregulation

Of all the metabolic effects of some of the atypical second-generation antipsychotics, their potential to induce glucose dysregulation has induced a storm of controversy over the past several years. The numerous published epidemiologic studies are difficult to interpret due to the high background rate of type 2 diabetes mellitus in this population, the inherent problems with analysis of observational data, and the short duration of the available studies. A plan to monitor for weight gain, hypertriglyceridemia, glucose dysregulation, and other potential adverse metabolic effects resulting from antipsychotic treatment is critical.

Risk of Treatment-Emergent Diabetes Mellitus in Patients Receiving Antipsychotics

2007 ◽  
Vol 41 (10) ◽  
pp. 1593-1603 ◽  
Author(s):  
Leslie L Citrome ◽  
Richard IG Holt ◽  
Woodie M Zachry ◽  
Jerry D Clewell ◽  
Paul A Orth ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
English Language ◽  
First Generation ◽  
Second Generation ◽  
Attributable Risk ◽  
Antipsychotic Treatment ◽  
Sufficient Information ◽  
Second Generation Antipsychotics ◽  
Risk Of Treatment

Background: Type 2 diabetes mellitus has been reported during antipsychotic treatment. Objective: To quantify the potential risk of treatment-emergent diabetes mellitus among patients receiving antipsychotic medications. Methods: The MEDLINE and Psychinfo databases were searched using the key words antipsychotic (including individual drug names), diabetes, risk, and incidence for all English-language articles published between 1966 and 2005. Risk calculations were performed using data obtained from pharmacoepidemiologic studies that met the following criteria: (1) cohort design, (2) determination of preexisting diabetes, (3) inclusion of antipsychotic monotherapy as an exposure variable, and (4) comparison with exposure to first-generation antipsychotics. Studies meeting these criteria were used to calculate incidence, attributable risk between agents, and number needed to harm. Results: A total of 25 observational pharmacoepidemiologic studies were found comparing antipsychotics on the outcome of diabetes mellitus. Sufficient information was provided in 15 of the reports to be able to estimate attributable risk, Attributable risk for individual second-generation antipsychotics relative to first-generation antipsychotics ranged from 53 more to 46 fewer new cases of diabetes per 1000 patients. Little observable difference was noted between the individual second-generation antipsychotics versus first-generation antipsychotics on this outcome. However, few of the studies controlled for body weight, race or ethnicity, or the presence of diabetogenic medications. None adjusted for familial history of diabetes, levels of physical activity, or diet, as this information is not usually available in the databases used in pharmacoepidemiologic studies. Conclusions: Based on the published pharmacoepidemiologic reports reviewed, the avoidance of diabetes as an outcome cannot be predictably achieved with precision by choice of a second- versus a first-generation antipsychotic. Risk management for new-onset diabetes requires the assessment of established risk factors such as family history, advancing age, non-white ethnicity, diet, central obesity, and level of physical activity.

scholarly journals The Relative Risk of Developing Type 2 Diabetes Mellitus in Young Adults with Schizophrenia Treated with Different Atypical Antipsychotic

2019 ◽  
Vol 26 (4) ◽  
pp. 445-453
Author(s):  
Nicolae-Marius Cason ◽  
Petru Aurel Babeș ◽  
Enikő Béres ◽  
Katalin Babeș
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Young Adults ◽  
Relative Risk ◽  
Cumulative Incidence ◽  
Normal Population ◽  
Metabolic Effects ◽  
Antipsychotic Treatment

Abstract Background and aim: While the link between antipsychotic treatment and metabolic adverse events, including type 2 diabetes mellitus (T2DM) are clear in adults with schizophrenia, in young this association is not so well studied although the use of secondgeneration antipsychotics (SGA) is more and more frequent. Material and methods: The local diabetes register was compared with the list of all registered young adults (18-35 years) with schizophrenia 2 years retrospective and 2 years prospective. Cumulative incidence, rate of incidence and relative risk was calculated knowing the number of persons in this age group within this region. Results: Cumulative incidence for exposed group was 0.7% with a rate of incidence of 6.27 (95%CI: 4.1-10.5) per 1,000 patientyears, when in normal population was 0.2%, respectively 2.01 (95%CI: 0.72-3.79). This means a relative risk of 3.4736 (95%CI: 1.79-6.72), p=0.0002 and NNH=202 (95%CI: 134-404). Multivariate analysis showed that gender male (OR=1.83; 95%CI: 0.9-2.7; p=0.002) and olanzapine prescription (OR=4.76; 95%CI: 1.7-7.7; p=0.0001) were independent risk factors for T2DM. Conclusions: The metabolic risk should be taken in account every time introducing or changing a SGA in young schizophrenic patient, balancing the benefits and negative metabolic effects (especially with olanzapine). Healthy nutrition and physical activities are necessary components of these patients lifestyle to avoid early onset of T2DM.

Metabolic effects of add-on probiotics supplementation in Cameroonian patients with uncontrolled type 2 diabetes mellitus (T2DM)

2018 ◽  
Vol 1 ◽  
Author(s):  
Raicha Namba ◽  
Eugène Sobngwi ◽  
Andréa Omengue ◽  
Armand Mbanya ◽  
Jean-Claude Njabou Katte ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Effects

Bile acids and the metabolic syndrome

2019 ◽  
Vol 56 (3) ◽  
pp. 326-337 ◽  
Author(s):  
Emma Rose McGlone ◽  
Stephen R Bloom
Keyword(s):  
Diabetes Mellitus ◽  
Bile Acid ◽  
Bile Acids ◽  
Fatty Liver Disease ◽  
Metabolic Diseases ◽  
Metabolic Effects ◽  
Alcoholic Fatty Liver ◽  
The Metabolic Syndrome ◽  
Alcoholic Fatty Liver Disease

Bile acids have important roles in the regulation of lipid, glucose and energy metabolism. Metabolic diseases linked to obesity, including type 2 diabetes mellitus and non-alcoholic fatty liver disease, are associated with dysregulation of bile acid homeostasis. Here, the basic chemistry and regulation of bile acids as well as their metabolic effects will be reviewed. Changes in circulating bile acids associated with obesity and related diseases will be reviewed. Finally, pharmaceutical manipulation of bile acid homeostasis as therapy for metabolic diseases will be outlined.

Quality of monitoring for metabolic effects associated with second generation antipsychotics in patients with schizophrenia on public insurance

2011 ◽  
Vol 126 (1-3) ◽  
pp. 117-123 ◽  
Author(s):  
Karen E. Moeller ◽  
Sally K. Rigler ◽  
Angela Mayorga ◽  
Niaman Nazir ◽  
Theresa I. Shireman
Keyword(s):  
Second Generation ◽  
Metabolic Effects ◽  
Public Insurance ◽  
Second Generation Antipsychotics
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