Hyperglycemia and hypertriglyceridemia in real world patients on antipsychotic therapy

There have been recent reports in the psychiatric literature of the possible association of glucose dysregulation and diabetes mellitus with the use of atypical antipsychotics. This article describes a retrospective chart review of patients from various clinical settings, including a continuing day treatment program, two inpatient programs, and a large private practice. Information was obtained with regard to weight, fasting blood glucose, lipid profiles, EKG changes, and medical comorbidities. The patients included those treated with conventional antipsychotic agents, clozapine, risperidone, olanzapine, and quetiapine. No one antipsychotic agent was associated with a statistically significantly higher prevalence of diabetes, lipid abnormalities, or EKG problems. It was noted, however, that there were higher rates of diabetes (17%), lipid abnormalities (43%), and hypertension (30%) across the sample. This finding suggests that the high prevalence of diabetes, lipid abnormalities, and hypertension in a young, chronically psychiatrically ill population makes the case for aggressive screening.