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A prospective study of impairment in glucose control caused by clozapine without changes in insulin resistance
Oliver D Howes1, Ajay Bhatnagar, Fiona P Gaughran
1Division of Psychological Medicine, Insitute of Psychiatry, London, UK. sphaoah@iop.kcl.ac.uk
Objective:
This prospective study examines the effect of clozapine on glucose control and insulin sensitivity.
Method:
Glucose homeostasis was measured in nine female and 11 male patients with schizophrenia (mean age=30.5 years, SD=7.4) before clozapine treatment and after a mean of 2.5 months (SD=0.95) of clozapine treatment. Oral glucose tolerance and insulin levels were measured. Insulin resistance level was measured by the homeostasis model assessment.
Results:
Eleven (55%) of the patients developed abnormal glucose control; the mean age of these patients was 30.2 (SD=7.1), and five were women. Patients' insulin resistance at baseline (mean insulin resistance level=3.88, SD=2.93) was unaffected by clozapine. Mean fasting and 2-hour glucose levels significantly increased by 0.55 mmol/liter and 1.4 mmol/liter, respectively. There was no correlation between change in body mass index and change in fasting glucose levels.
Conclusions:
Clozapine impairs glucose control within 4 months of treatment, independent of changes in insulin sensitivity and body mass index.
