Atypical antipsychotic-induced diabetes mellitus: an update on epidemiology and postulated mechanisms.
Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome are rare, but potentially fatal complications of antipsychotic-associated hyperglycaemia. The mechanisms for this remain unclear, but are probably multifactorial. The suggested reasons include drug-induced weight gain and adiposity, development of the metabolic syndrome, antagonism of serotonin (5-hydroxytryptamine) receptors, drug-induced leptin resistance, dyslipidaemia mediated pancreatic beta-cell damage and hepatocyte transcription factor dysregulation. Patients with schizophrenia are known to be at a higher genetic risk of developing diabetes mellitus and cardiovascular disease. This review emphasizes a rare case of hyperosmolar hyperglycaemic syndrome in a young man with schizophrenia and discusses proposed mechanisms for the development of antipsychotic-associated diabetes mellitus.
Buchholz
S
S
Department of Medicine, Nambour General Hospital, Nambour, Queensland, Australia. stefanbuchholz@hotmail.com
Morrow
A F
AF
Coleman
P L
PL
D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology*; D006801:Humans; D008297:Male
D014150:Antipsychotic Agents; D001786:Blood Glucose