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Type 2 Diabetes and Antipsychotic Use

Meta-analysis evaluates prevalence in youths

Type 2 diabetes may be more common in young people who take antipsychotics than previously thought, according to a meta-analysis involving 13 studies and more than 1.8 million individuals.

Participants included those exposed to antipsychotics (n=185,105), psychiatric controls (n=1.34 million), and healthy controls (n=298,803).

Among the results:

• Antipsychotic-exposed youths had a cumulative diabetes risk of 5.72/1000 patients, and their incidence rate was 3.09/1000 patient years.

• They were more than 2.5 times more likely than healthy controls to develop diabetes, and more than twice as likely as psychiatric controls to do so.

• Incidence rate ratios vs healthy and psychiatric controls were 3.02 and 1.79, respectively.

In multivariate analyses of 10 studies:

• Greater cumulative diabetes risk was tied to longer follow-up, taking olanzapine, and being male.

• Greater incidence was associated with taking 2nd-generation antipsychotics and less autism spectrum disorder diagnosis.

The authors noted that olanzapine treatment and antipsychotic exposure time were the main modifiable risk factors, and they urged judicious use for the shortest possible duration.

Citation: Galling B, Roldan A, Nielson R, et al. Type 2 diabetes mellitus in youth exposed to antipsychotics: A systematic review and meta-analysis. [Published online ahead of print January 20, 2016] JAMA Psychiatry. doi:10.1001/jamapsychiatry.2015.2923.