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Metabolic Monitoring among Patients with Type 2 Diabetes Prescribed Second Generation Antipsychotics
Jiali Guo1,2, Jithin Sam Varghese1,2
1Emory Global Diabetes Research Center of Woodruff Health Sciences Center and Emory University, Atlanta, GA.
AMIA ... Annual Symposium Proceedings. AMIA Symposium
|February 23, 2026
Summary
Annual metabolic monitoring is crucial for type 2 diabetes (T2D) patients on second-generation antipsychotics (SGA). Monitoring rates declined over time, potentially impacting T2D complication risk management.
Area of Science:
- Endocrinology
- Psychiatry
- Pharmacology
Background:
- Annual metabolic monitoring is recommended for type 2 diabetes (T2D) patients prescribed second-generation antipsychotics (SGA).
- Antipsychotic medications, particularly SGAs, are associated with metabolic side effects.
- Understanding monitoring practices is crucial for managing T2D complications in patients on SGAs.
Purpose of the Study:
- To assess metabolic monitoring rates (weight, HbA1c, LDL, renal function) in T2D patients after SGA prescription.
- To compare monitoring rates between patients prescribed SGAs, first-generation antipsychotics (FGA), and neither.
- To evaluate metabolic control rates in these patient groups.
Main Methods:
- Retrospective cohort study using Epic Cosmos data (469,503 adults).
- Estimated monitoring and metabolic control rates for Years 1-3 post-index prescription.
- Used marginal logistic models, adjusting for covariates like demographics, clinical factors, and comorbidities.
Main Results:
- Monitoring rates for weight, HbA1c, LDL, and renal function declined across all years for both SGA and FGA groups.
- Renal function monitoring was higher in Year 1 for SGA/FGA groups compared to controls; HbA1c and LDL monitoring were lower.
- Metabolic control rates were above national averages but similar across groups and over time.
Conclusions:
- Declining metabolic monitoring in T2D patients on SGAs may impede risk management for diabetes complications.
- Despite similar metabolic control, reduced monitoring raises concerns for long-term patient outcomes.
- Enhanced monitoring strategies are needed for T2D patients prescribed SGAs.
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