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4 April 2006
Research findings reveal that the risk of Type 2 diabetes in patients with schizophrenia is similar for those taking typical and atypical antipsychotics, but the duration of exposure to such medications does not appear to be an influencing factor.
In their study of more than 200 patients with schizophrenia, D Cohen, from the Psychiatric Institute Rijngeest in Noordwijkerhout, The Netherlands, and colleagues found that the overall prevalence of Type 2 diabetes was 9%, which was significantly higher than the prevalence of 4.9% for the general population.
With regard to atypical or typical antipsychotics, they therefore suggest in the journal European Neuropsychopharmacology that, "whichever treatment is applied, the result in the long term is the same, namely an increase of risk of diabetes mellitus."
The researchers investigated the prevalence of diabetes in 266 patients with chronic schizophrenia or schizoaffective disorder and whether it was related to the duration of antipsychotic treatment.
Compared with estimates for the general population, patients with schizophrenia were found to be 1.89 times more likely to develop diabetes. There were no new cases of diabetes mellitus during the course of the study, however.
Cohen and co-workers note that the increased prevalence of diabetes was largely confined to patients aged between 30 and 39 years and those aged 40 to 49 years, with odds ratios of 13.29 and 6.74, respectively, compared with people of the same age from the general population.
The increased prevalence of diabetes appeared to be associated with being overweight and obese, but there was no significant correlation between diabetes and the duration of antipsychotic treatment.
Moreover, there was no relationship between diabetes and the prescribed antipsychotic drug or biochemical group of antipsychotic drugs.
"Irrespective of the pathophysiological mechanism involved, the results warrant modified indications for blood glucose control in long-term treated patients," the researchers say.
They note that the diabetes consensus document from the American Diabetes Association advises blood glucose control during treatment with atypical antipsychotics. But, based on the current findings, Cohen and team suggest that differentiation between typical and atypical antipsychotics is not needed. (выделение мое- И.Г.)
Moreover, no age limit is indicated in the current guidelines, whereas these results suggest that blood glucose control from the age of 30 onwards is needed in order to detect hyperglycemia or early cases of diabetes mellitus.
Source: Eur Neuropsychopharmacol 2006; 16: 187–194
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