title: Antipsychotic drugs and the risk of hyperglycemia in older adults without diabetes:  a population-based observational study.
abstract: OBJECTIVE
  To determine whether current antipsychotic use among older persons without diabetes is associated with a higher risk of hospital visits for hyperglycemia, as previous studies in this population have yielded conflicting results.
  
  
  METHODS
  A nested case-control study within a population-based cohort of persons aged 66 years or older without diabetes, who initiated antipsychotic therapy between April 1, 2002, and March 31, 2006. Cohort members were identified using health databases from Ontario, Canada, and were followed from treatment start until March 31, 2007.
  
  
  METHODS
  Cases were patients with a hospital visit (emergency department visit or hospital admission) for hyperglycemia. We matched each case with up to 10 controls. We compared the risk of hyperglycemia among current antipsychotic users to that of remote users (discontinued > 180 days).
  
  
  RESULTS
  The cohort consisted of 44,121 subjects, mean age of 78.3 years, followed for a mean of 2.2 years. Compared to remote antipsychotic use, current treatment with any antipsychotic was associated with a significantly increased risk of hospital visits for hyperglycemia (adjusted odds ratio [aOR]: 1.52; 95% confidence interval [CI]: 1.07-2.17). The risk was elevated for both atypical (aOR: 1.44; 95% CI: 1.01-2.07) and typical (aOR: 2.86; 95% CI: 1.46-5.59) antipsychotic agents.
  
  
  CONCLUSIONS
  Current use of either atypical or typical antipsychotic agents was associated with a significantly increased risk of hospital visits for hyperglycemia among older persons without diabetes. These findings highlight the need for close glucose monitoring during antipsychotic therapy in older populations.
authors: Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. Lorraine.Lipscombe@wchospital.ca
authors: Lorraine L
authors: LL
authors: Lipscombe
authors: Linda E
authors: LE
authors: Lévesque
authors: Andrea
authors: A
authors: Gruneir
authors: Hadas D
authors: HD
authors: Fischer
authors: David N
authors: DN
authors: Juurlink
authors: Sudeep S
authors: SS
authors: Gill
authors: Nathan
authors: N
authors: Herrmann
authors: Janet E
authors: JE
authors: Hux
authors: Geoff M
authors: GM
authors: Anderson
authors: Paula A
authors: PA
authors: Rochon
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000378:metabolism*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D008297:Male; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors
chemical_list: D014150:Antipsychotic Agents