Type 2 Diabetes - Antipsychotic Drugs and Prediabetes

It has been found people of varying ages treated with antipsychotic drugs have a high risk of developing Type 2 diabetes, and the medications are thought to be related to increased abdominal fat and insulin resistance.
Investigators at Zucker Hillside Hospital in Glen Oaks, New York, United States, looked at various indicators or measures of prediabetes to determine whether patients treated for psychosis need to be treated for prediabetes before full-blown diabetes can develop.
Their study, published November 2011 in the Journal of Clinical Psychiatry, included 783 adult psychiatric patients with no history of diabetes, all being treated with antipsychotic medications.
Over the course of about four years...

• 413 patients had normal blood sugar levels,
• 290 developed prediabetes, and
• 80 developed Type 2 diabetes.
  

According to the American Diabetes Association (ADA), people with fasting blood sugar levels of 100 to 125 mg/dL (5.
5 to 6.
9 mmol/L), or blood sugar levels of 140 to 199 mg/dL (7.
7 to 11 mmol/L), 2 hours after eating 75 grams of sugar, or a HbA1c level of 5.
7 to 6.
4 per cent should be considered prediabetic and at risk for the development of Type 2 diabetes.
The ADA recommends treating prediabetes with metformin before full-blown Type 2 diabetes can develop.
Only 19 of the patients in the above study met the ADA criteria for being treated with metformin.
From the above research, it was suggested prediabetics taking antipsychotic drugs might need new criteria for treatment with metformin to prevent Type 2 diabetes developing.
Olanzapine and clozapine are classified as atypical antipsychotics.
Clozapine is used to treat schizophrenia and to prevent suicide.
Olanzapine is also used in the treatment of schizophrenia, as well as bipolar (manic-depressive) disorder.
In 2001 the Journal of Clinical Psychiatry published a review of the literature on atypical psychotics and blood sugar levels.
According to the article, reports on individual patients, medical records and drug trials associated high blood sugar levels with both drugs.
Removal of either drug resulted in lowered blood sugar levels, which were increased when the drug was restarted.
Controlling psychosis is extremely important despite the possibility of developing Type 2 diabetes.
Anyone on atypical antipsychotics should discuss with their doctor the possibility of measuring their blood sugar levels and HbA1c levels or of being tested for insulin resistance.
Everyone is advised to maintain a normal healthy weight, exercise daily, and eat lots of fruits, vegetables, and whole grains, to maintain insulin sensitivity and help to prevent developing Type 2 diabetes.