Exploring the association between atypical neuroleptic agents and diabetes mellitus in older adults.
OBJECTIVE
To explore the suggested association between atypical neuroleptic use and the development of diabetes mellitus, with a focus on older adults.


METHODS
Retrospective cohort study.


METHODS
Eleven thousand one hundred four older (> 65 yrs) residents of long-term care institutions in Ontario, Canada, who received either atypical neuroleptic agents, typical neuroleptic agents, benzodiazepines, or corticosteroids.


RESULTS
Each subject was followed for the development of a diabetic event, defined as newly prescribed antidiabetic drug therapy. Our Cox regression model was adjusted for age, sex, socioeconomic status, comorbidity, and concomitant use of beta-blockers, thiazide diuretics, and antiepileptic agents. The adjusted hazard ratio for the development of diabetes in patients receiving atypical neuroleptics compared with those receiving benzodiazepines (control group) was 0.89 (95% confidence interval [CI] 0.66-1.21). The adjusted hazard ratio for typical neuroleptic users compared with the benzodiazepine group was 1.27 (95% CI 0.91-1.77). As expected, patients receiving corticosteroid therapy were almost twice as likely to develop diabetes as those receiving benzodiazepines (adjusted hazard ratio 2.2, 95% CI 1.41-3.12). For patients receiving atypical neuroleptic agents, no statistically significant difference in the percentage of diabetic events was found among individual agents (2.1% olanzapine, 1% quetiapine, 2.1% risperidone).


CONCLUSIONS
Drug therapy with atypical neuroleptic agents in older adults did not increase their risk of developing diabetes mellitus.
Etminan
Mahyar
M
Department of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada. Mahyar.etminan@mail.mcgill.ca
Streiner
David L
DL
Rochon
Paula A
PA
D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000139:chemically induced / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012189:Retrospective Studies
D014150:Antipsychotic Agents