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Oral glucose tolerance tests in treated patients with schizophrenia.

Data to support an adaptation of the proposed guidelines for monitoring of patients on second generation antipsychotics?

Published online by Cambridge University Press:  16 April 2020

Marc De Hert ,
Dominique Van Eyck ,
Linda Hanssens ,
Hendrik Peuskens ,
Erik Thys ,
Martien Wampers ,
Andre Scheen  and
Jozef Peuskens
Marc De Hert*
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Dominique Van Eyck
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Linda Hanssens
Affiliation:
Department of Epidemiology and Public Health, University of Liége, Liége, Belgium
Hendrik Peuskens
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Erik Thys
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Martien Wampers
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
Andre Scheen
Affiliation:
Service of Diabetology, CHU de Sart Tilman, University de Liége, Liége, Belgium
Jozef Peuskens
Affiliation:
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070Kortenberg, Belgium
*
*Corresponding author. Tel.: +32 2 758 0546; fax: +32 2759 5380. E-mail address: marc.de.hert@uc-kortenberg.be (M. De Hert).
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Abstract

Objective

A recent consensus conference has proposed guidelines for the monitoring for diabetes in patients with schizophrenia and also identifies the need of long-term prospective studies.

Methods

A large scale prospective study on metabolic risks of antipsychotic medication is currently ongoing. At baseline, patients get a full laboratory screening, ECG and an oral glucose tolerance test (OGTT). Baseline data on 100 non-diabetic patients at study inclusion and stable on medication for at least 6 months are presented.

Results

Glucose abnormalities are found in 22% of patients at baseline. A monitoring protocol based only on fasting glucose would not have detected 63.6% of these patients with classifiable glucose abnormalities in our sample. Fasting insulin and measures for insulin resistance have a high predictive value for abnormalities late in the OGTT.

Conclusions

Already at baseline, metabolic problems are frequently present in patients with schizophrenia treated with antipsychotics. Adding assessment of fasting insulin in a monitoring protocol improves detection of glucose abnormalities late in an OGTT.

Keywords

SchizophreniaDiabetesMetabolic syndromeAntipsychotics
Type
Original articles
Information
European Psychiatry , Volume 21 , Issue 4 , June 2006 , pp. 224 - 226
Copyright
Copyright © European Psychiatric Association 2006

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References

American Diabetes Association Consensus development conference on antipsychotic drugs and obesity and diabetes. Diabetes Care 2004;27(2):596–601.CrossRefGoogle Scholar
Caro, JJ, Ward, A, Levinton, C, Robinson, KThe risk of diabetes during olanzapine use compared with risperidone use: a retrospective database analysis. J. Clin. Psychiatry 2002;63(12):1135–1139.CrossRefGoogle ScholarPubMed
Citrome, LL, Jaffe, ABRelationship of atypical antipsychotics with development of diabetes mellitus. Ann. Pharmacother. 2003;37:1849–1857.CrossRefGoogle ScholarPubMed
De Hert, M, Hanssens, L, de Patoul, A, Peuskens, JPharmacological treatment of ambulatory schizophrenic patients in Belgium. Schiz. Res. 2004;67 (Abstracts Winter Workshop on Schizophrenia).Google Scholar
De Nayer, A, DeHert, M, Scheen, Aet al.Belgian consensus on metabolic problems associated with second generation antipsychotics. Int. J. Psychiatry Clin. Pract. 2005;9:130–137.CrossRefGoogle Scholar
Ebenbilcher, C, Laimer, M, Eder, U, Mangwerth, B, Weiss, E, Hofer, Aet al.Olanzapine induced insulin resistance: results from a prospective study. J. Clin. Psychiatry 2003;64(12):1436–1439.CrossRefGoogle Scholar
Ereshefsky, LPharmacokinetics and drug interactions: update for new antipsychotics. J. Clin. Psychiatry 2002;57:12–15.Google Scholar
Expert Committee on the Diagnosis and Classification of Diabetes Mellitus Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 2003;26(Suppl 1):S5–S20.CrossRefGoogle Scholar
Expert Group Schizophrenia and diabetes 2003. Expert consensus meeting, Dublin 3–4 October 2003: consensus summary. Brit. J. Psy. 2004;184:S112–S114.CrossRefGoogle Scholar
Expert Panel on Detection Evaluation and treatment of blood cholesterol in adults. Extensive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on detection, evaluation and treatment of high blood cholesterol in adults. JAMA 2001;285:2486–2497.CrossRefGoogle Scholar
Gianfrancesco, F, White, R, Wang, RH, Nasrallah, HAAntipsychotic-induced type 2 diabetes: evidence from a large health plan database. J. Clin. Psychopharmacol. 2003;23(4):328–335.CrossRefGoogle ScholarPubMed
Hedenmalm, K, Hagg, S, Stahl, M, Mortimer, O, Spigset, OGlucose intolerance with atypical antipsychotics. Drug Saf. 2002;25(15):1107–1116.CrossRefGoogle ScholarPubMed
Henderson, DCAtypical antipsychotic-induced diabetes mellitus, how strong is the evidence. CNS Drugs 2002;16:77–89.CrossRefGoogle ScholarPubMed
Howes, OD, Bhatnagar, A, Gaugran, FP, Amiel, SA, Murray, RM, Pilowsky, LSA prospective study of impairement in glucose control caused by clozapine without changes in insulin resistance. Am. J. Psychiatry 2004;161:361–363.CrossRefGoogle Scholar
Lean, ME, Pajonk, FGPatients on atypical antipsychotic drugs: another high-risk group for type 2 diabetes. Diabetes Care 2003;26(5):1597–1605.CrossRefGoogle Scholar
Lorenzo, C, Okoloise, M, Williams, K, Stern, MP, Haffner, SMThe metabolic syndrome as predictor of Type-2 diabetes. Diabetes Care 2003;26:3153–3159.CrossRefGoogle ScholarPubMed
Lindenmayer, JP, Czobor, P, Volavka, J, Citrome, LL, Sheitman, B, McEvoy, JPet al.Changes in glucose and cholesterol levels in patients with schizophrenia treated with typical and atypical antipsychotics. Am. J. Psychiatry 2003;160:290–296.CrossRefGoogle ScholarPubMed
Melkersson, K, Dahl, M.-L.Adverse metabolic effects associated with atypical antipsychotics. Drugs 2004 701–723.CrossRefGoogle ScholarPubMed
Newcomer, JW, Haupt, DW, Fucetola, R, Melson, AK, Schweiger, JA, Cooper, BPet al.Abnormalities in glucose regulation during antipsychotic treatment. Arch. Gen. Psychiatry 2002;59:337–345.CrossRefGoogle ScholarPubMed
Sernyak, MJ, Leslie, DL, Alarcon, RD, Losonczy, MF, Rosenheck, RAssociation of diabetes mellitus with use of atypical neuroleptics in the treatment of schizophrenia. Am. J. Psychiatry 2002;159(4):561–566.CrossRefGoogle ScholarPubMed
Stern, MP, Williams, K, Haffner, SMIdentification of persons at high risk for Type-2 diabetes: do we need the oral glucose tolerance test. Ann. Intern. Med. 2002;136:575–581.CrossRefGoogle ScholarPubMed
Wampers, M, De Hert, M, Van Eyck, D, Peuskens, JSomatic medication in hospitalised schizophrenic patients in Belgium. Schiz. Res. 2004;67 (Abstracts Winter Workshop on Schizophrenia).Google Scholar
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