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?
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.
De Hert
Marc
M
University Centre Sint-Jozef, Katholieke Universiteit Leuven, Leuvensesteenweg 517, 3070 Kortenberg, Belgium. marc.de.hert@uc-kortenberg.be
Van Eyck
Dominique
D
Hanssens
Linda
L
Peuskens
Hendrik
H
Thys
Erik
E
Wampers
Martien
M
Scheen
Andre
A
Peuskens
Jozef
J
D000328:Adult; D014150:Antipsychotic Agents / Q000378:metabolism* / Q000627:therapeutic use; D001530:Belgium; D004562:Electrocardiography / Q000379:methods; D005260:Female; D044882:Glucose Metabolism Disorders / Q000139:chemically induced / Q000175:diagnosis*; D005951:Glucose Tolerance Test; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D017410:Practice Guidelines as Topic; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents