Association Between Antipsychotic Medication Use and Diabetes

• Published in: Current diabetes reports Vol. 19; no. 10; pp. 96 - 10
• Main Author: Holt, Richard I. G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2019; Springer Nature B.V
• Subjects: Antipsychotic Agents - adverse effects; Antipsychotic Agents - pharmacology; Antipsychotic Agents - therapeutic use; Antipsychotics; Diabetes; Diabetes Mellitus - chemically induced; Diabetes Mellitus - epidemiology; Diabetes Mellitus - physiopathology; Diabetes Mellitus - therapy; Humans; Insulin resistance; Insulin Resistance - physiology; Medicine; Medicine & Public Health; Mental disorders; Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit; Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors); Psychotic Disorders - drug therapy; Psychotic Disorders - epidemiology; Psychotic Disorders - etiology; Psychotropic drugs; Section Editors; Topical Collection on Other Forms of Diabetes and Its Complications; Weight Gain - drug effects; Weight Gain - physiology; Antipsychotics; Insulin resistance; β-cell dysfunction; Diabetes; Weight gain
• ISSN: 1534-4827; 1539-0829
• DOI: 10.1007/s11892-019-1220-8

Purpose of Review The prevalence of diabetes is 2–3-fold higher in people with severe mental illness than the general population. There are concerns that antipsychotics increase the risk of diabetes. This review will examine the latest epidemiological studies linking antipsychotics and diabetes, as well as the mechanisms underlying the association and the clinical implications to minimise the impact of antipsychotics on metabolic health. Recent Findings Although there is an increased risk of diabetes in people with first-episode psychosis, the prevalence increases rapidly after antipsychotics are started. Antipsychotics likely increase the risk of diabetes through weight gain and directly by adversely affecting insulin sensitivity and secretion. Summary It is important to implement measures to prevent diabetes, to screen for diabetes to ensure prompt diagnosis and to provide effective diabetes care. Further research is needed to understand how antipsychotics cause diabetes and to improve the clinical management of diabetes in people with severe mental illness.