Atypical antipsychotic drugs, diabetes and ethnicity.

There are 17 million people affected by diabetes in the US. It is a syndrome consisting of metabolic abnormalities, microvascular and macrovascular disease leading to cardiac, renal and neurological abnormalities. Obesity is the most common public health problem in developed nations. Diabetes and obesity-related illnesses are common in ethnic minorities such as African-Americans, Hispanics and Asians related to both genetics and lifestyle patterns. In all ethnic minorities in the US, an increase in Type 2 diabetes has been observed. However, the Asian group experienced the highest rate of increase in prevalence between the years 1990 and 1998. The changing ethnic composition of the US population may contribute significantly to the worsening of the diabetes epidemic in this country. Atypical antipsychotic drugs can induce diabetes, as well as obesity. All atypical antipsychotic drugs can produce diabetes, but drugs such as olanzapine and clozapine have been known to produce diabetes more often than other drugs. As ethnic minority patients including Asians, Hispanics and African-Americans are predisposed to develop diabetes, antipsychotics become a burden by precipitating diabetes. Such a situation poses a problem in treating ethnic minority psychiatric patients. In clinical situations, close monitoring is necessary to prevent metabolic side effects of these drugs.