title: Comparison of glycemic and metabolic control in youth with type 1 diabetes with and without antipsychotic medication: analysis from the nationwide German/Austrian Diabetes Survey (DPV).
abstract: OBJECTIVE
  The objective of this study was to explore metabolic risk factors and glycemic control in youth with type 1 diabetes treated with typical or atypical antipsychotics.
  
  
  METHODS
  Data for 60,162 subjects with type 1 diabetes up to the age of 25 years registered in the nationwide German/Austrian Diabetes Survey were included in the analysis. BMI; HbA1c; treatment strategy; prevalence of hypertension, dyslipidemia, microalbuminuria, and retinopathy; frequency of hypoglycemia and diabetic ketoacidosis (DKA); and immigrant status among subjects treated with typical or atypical antipsychotics were compared with those without antipsychotic medication and analyzed by regression analysis.
  
  
  RESULTS
  A total of 291 subjects with type 1 diabetes (median diabetes duration 7.2 years) received antipsychotic medications (most commonly risperidone). Subjects treated with antipsychotics had a higher BMI (P = 0.004) and dyslipidemia was more frequent (P = 0.045) compared with subjects not receiving antipsychotic medication. Frequencies of severe hypoglycemia and DKA were significantly higher in subjects receiving antipsychotics (P < 0.001). The prevalences of hypertension, microalbuminuria, and retinopathy were not different. In subjects treated with typical antipsychotics, glycemic control did not differ compared with those who did not receive antipsychotic medications. By contrast, subjects treated with atypical antipsychotics had higher HbA1c levels (P = 0.022).
  
  
  CONCLUSIONS
  This analysis from a real-life survey demonstrated that subjects with antipsychotic medication had worse glycemic control and a higher rate of acute complications compared with those without antipsychotic medication. Health care teams caring for youth with type 1 diabetes taking antipsychotic medication need to know about these findings. We suggest monitoring metabolic risk factors as well as providing diabetes education about prevention of acute complications.
authors.affiliation: Charité-Universitätsmedizin Berlin, Paediatric Endocrinology and Diabetology, University Hospital for Children and Adolescents, Campus Virchow Klinikum, Berlin, Germany angela.galler@charite.de.
authors.forename: Angela
authors.initials: A
authors.lastname: Galler
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: Esther
authors.initials: E
authors.lastname: Bollow
authors.affiliation: Gemeinschaftskrankenhaus Herdecke, Child and Adolescent Psychiatry, Herdecke, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Meusers
authors.affiliation: Filderklinik Paediatrics, Filderstadt, Germany.
authors.forename: Bela
authors.initials: B
authors.lastname: Bartus
authors.affiliation: University Carl Gustav Carus Dresden, University Hospital for Children and Adolescents, Dresden, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Näke
authors.affiliation: Sana Hospital Berlin Lichtenberg, Hospital for Children and Adolescents, Berlin, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Haberland
authors.affiliation: Medical University Vienna, University Hospital for Children and Adolescents, Vienna, Austria.
authors.forename: Edith
authors.initials: E
authors.lastname: Schober
authors.affiliation: Institute of Epidemiology and Medical Biometry, University of Ulm, Ulm, Germany.
authors.forename: Reinhard W
authors.initials: RW
authors.lastname: Holl
mesh_terms: D000293:Adolescent; D000328:Adult; D000419:Albuminuria / Q000139:chemically induced; D014150:Antipsychotic Agents / Q000009:adverse effects*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D048909:Diabetes Complications / Q000139:chemically induced; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000523:psychology; D016883:Diabetic Ketoacidosis / Q000139:chemically induced; D003930:Diabetic Retinopathy / Q000139:chemically induced; D050171:Dyslipidemias / Q000139:chemically induced; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007003:Hypoglycemia / Q000139:chemically induced; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D018967:Risperidone / Q000009:adverse effects; D012559:Schizophrenia / Q000188:drug therapy; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D018967:Risperidone