Wilson Daniel R, D'Souza Leo, Sarkar Nibar, Newton Michael, Hammond Connie
Department of Psychiatry, Creighton University School of Medicine, Omaha, NE 68131, USA.
Schizophr Res. 2003 Jan 1;59(1):1-6. doi: 10.1016/s0920-9964(01)00331-0.
Information from the Ohio Department of Mental Health (ODMH) database was reviewed retrospectively to identify patients at the Cincinnati center treated with an atypical antipsychotic and who had also been evaluated or treated for diabetes mellitus. Blood glucose levels, glucose tolerance, or other evaluations of diabetes had been conducted in 14 of the 126 patients treated with atypical antipsychotics. In 11 of the 14, new-onset, acute, and marked glucose intolerance developed after treatment with clozapine, olanzapine or quetiapine. Of these, six patients required insulin therapy (four only transiently) and five patients developed diabetic ketoacidosis (DKA). Also, glucose metabolism was labile in all cases, and was transient in two cases with subsequent resolution despite on-going antipsychotic therapy. Certain atypical antipsychotics may be associated with new-onset glucose intolerance, including acute diabetes and ketoacidosis. Monitoring for changes in blood glucose levels in patients taking atypical antipsychotics may be indicated. More systematic study data are clearly needed.
对俄亥俄州心理健康部（ODMH）数据库中的信息进行回顾性审查，以确定在辛辛那提中心接受非典型抗精神病药物治疗且同时接受过糖尿病评估或治疗的患者。在126例接受非典型抗精神病药物治疗的患者中，有14例进行了血糖水平、葡萄糖耐量或其他糖尿病评估。在这14例患者中，有11例在使用氯氮平、奥氮平或喹硫平治疗后出现了新发、急性和明显的葡萄糖不耐受。其中，6例患者需要胰岛素治疗（4例仅为短暂治疗），5例患者发生了糖尿病酮症酸中毒（DKA）。此外，所有病例的糖代谢均不稳定，2例患者的糖代谢虽在持续抗精神病治疗期间出现短暂异常，但随后恢复正常。某些非典型抗精神病药物可能与新发葡萄糖不耐受有关，包括急性糖尿病和酮症酸中毒。对于服用非典型抗精神病药物的患者，可能需要监测血糖水平的变化。显然需要更多系统的研究数据。
