Atypical antipsychotic-induced diabetes mellitus: an update on epidemiology and postulated mechanisms

Internal Medicine Journal
S BuchholzP L Coleman

Abstract

Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome are rare, but potentially fatal complications of antipsychotic-associated hyperglycaemia. The mechanisms for this remain unclear, but are probably multifactorial. The suggested reasons include drug-induced weight gain and adiposity, development of the metabolic syndrome, antagonism of serotonin (5-hydroxytryptamine) receptors, drug-induced leptin resistance, dyslipidaemia mediated pancreatic beta-cell damage and hepatocyte transcription factor dysregulation. Patients with schizophrenia are known to be at a higher genetic risk of developing diabetes mellitus and cardiovascular disease. This review emphasizes a rare case of hyperosmolar hyperglycaemic syndrome in a young man with schizophrenia and discusses proposed mechanisms for the development of antipsychotic-associated diabetes mellitus.

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Citations

May 12, 2009·Schizophrenia Bulletin·Afke F Terwisscha van ScheltingaRené S Kahn
Aug 20, 2010·Diabetology & Metabolic Syndrome·Alfredo HalpernMarcia Nery
May 10, 2012·Neuropsychiatric Disease and Treatment·Silvio CacciaAlessandro Nobili
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