Testing for diabetes in hospitalised patients prescribed antipsychotic drugs

Taylor, David; Young, Corina; Esop, Raadiyya; Paton, Carol; Walwyn, Rebecca

doi:10.1192/bjp.185.2.152

Cited by 71 publications

(50 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This concurs with the results of previous studies (Gul et al, 2006;Mackin et al, 2007;Motsinger et al, 2006;Taylor et al, 2004).…”

Section: Discussionsupporting

confidence: 83%

See 1 more Smart Citation

Adherence to metabolic monitoring guidelines in atypical antipsychotic treated subjects: Do physicians comply?

Gill

Teong²,

Gee³

et al. 2012

Afr. J. Pharm. Pharmacol.

View full text Add to dashboard Cite

Since the 1990s, the arrival of the new generation of antipsychotics, the atypical antipsychotics (AAP), heralded a new era in the management on psychotic patients as they are associated with much less side effects as the older drugs. However, the psychiatric community soon realized a new problem had emerged with these drugs, namely severe metabolic side effects. Several monitoring guidelines were soon published to guide treating physicians on how to deal with this issue. This study was aimed to assess adherence to the recommended guidelines by Malaysian doctors. Data concerning metabolic monitoring over 1 year were collected from 405 subjects newly started on AAP after June 2005, when the recommended guidelines were first implemented. Results showed that almost all the recommended tests/procedures were performed in less than 50% of patients during the recommended designated times. We recommend that the guidelines, which now serve only as a "guide", be made a compulsory practice to safeguard the health of our patients.

show abstract

“…This concurs with the results of previous studies (Gul et al, 2006;Mackin et al, 2007;Motsinger et al, 2006;Taylor et al, 2004).…”

Section: Discussionsupporting

confidence: 83%

“…However, many studies found that monitoring was still poor (Motsinger et al, 2006;Taylor et al, 2004). A prospective cohort study in Northeast England that studied 83 subjects on antipsychotics revealed that none of them were monitored for their BMI and waist circumference.…”

Section: Introductionmentioning

confidence: 99%

Adherence to metabolic monitoring guidelines in atypical antipsychotic treated subjects: Do physicians comply?

Gill

Teong²,

Gee³

et al. 2012

Afr. J. Pharm. Pharmacol.

View full text Add to dashboard Cite

show abstract

“…All patients were taking atypical antipsychotic medication, but this association was not statistically significant. The prevalence of undiagnosed glycaemic disorder here is similar to that reported in a recent study in which case notes from hospitalised patients prescribed antipsychotic drugs were examined for evidence of testing for diabetes [25]. The study by Taylor et al reported a prevalence of glucose homeostasis disorder of 15.6% in those tested, and no association between the prevalence of hyperglycaemia and the type of antipsychotic medication was found.…”

Section: Discussionsupporting

confidence: 71%

Prevalence of obesity, glucose homeostasis disorders and metabolic syndrome in psychiatric patients taking typical or atypical antipsychotic drugs: a cross-sectional study

2005

View full text Add to dashboard Cite

Aims/hypothesis: Atypical antipsychotic drugs may be associated with obesity and other components of the metabolic syndrome, but this relationship is controversial. We investigated the hypothesis that atypical antipsychotics are associated with a greater degree of metabolic dysfunction than typical agents. Methods: Metabolic parameters were measured in 103 diagnostically heterogeneous psychiatric out-patients. Patients had been taking typical or atypical antipsychotic drugs for a minimum of six months. Results: Sixty-nine patients were taking atypical agents, 20 typical agents and 14 a combination. Mean values (±SD) for the whole group were: age 43.8 years (11.4); BMI 29.1 kg/m 2 (5.1); W:H ratio 0.88 (0.09). Metabolic parameters, including beta cell function and insulin sensitivity, measured by HOMA, did not differ with regard to the prescribed antipsychotic drug. Six patients had undiagnosed diabetes, six patients had impaired fasting glucose, and eight fulfilled criteria for the metabolic syndrome, all of whom were taking atypical agents (p=0.07 vs typical agents). Subgroup analyses of those taking atypical agents revealed differences in BMI (mean, ±SD) between olanzapine (27.3 kg/m 2 ±5.1) and quetiapine (31.9 kg/m 2 ±5.1), p=0.01, and HbA 1c (olanzapine, 5.1%±0.6 vs quetiapine, 5.6%±0.6; p=0.03). Other atypical agents were intermediate with regard to these parameters. Conclusions: Obesity, dyslipidaemia and abnormalities of glucose homeostasis are prevalent in this group. Patients taking atypical agents showed a trend towards abnormalities of glucose homeostasis. Prospective studies are needed to explore the precise relationship between antipsychotic drugs, glucose homeostasis, obesity and the metabolic syndrome.

show abstract

“…Screening for diabetes varies between different agents, with patients receiving second-generation antipsychotics being much more likely to be screened than those receiving 'typical' drugs [9,10]. This is important because as many as 70% of cases of diabetes in patients with schizophrenia are undiagnosed, and only through a systematic screening programme will all new cases of diabetes be identified [11].…”

Section: The Sources Of Evidence Linking Antipsychotic Drugs and Diabmentioning

confidence: 99%

“…An alternative explanation may be that the rate of diabetes in patients with SMI is increasing in line with the general population and any further increase reflects an increased awareness of the need to screen for diabetes in patients with SMI [9].…”

Section: Plausibilitymentioning

confidence: 99%

Antipsychotic drugs and diabetes—an application of the Austin Bradford Hill criteria

Holt

Peveler

2006

Diabetologia

View full text Add to dashboard Cite

There is concern that antipsychotic drugs cause diabetes. Although there has been an explosion in the quantity of literature about this subject, it remains confusing and inconsistent. To assess whether the association between antipsychotic drugs and diabetes is causative, we applied the Austin Bradford Hill criteria to the available evidence. In support of a causative relationship, there is temporality for some cases of diabetes, and there is a biologically plausible explanation. The causative link between antipsychotic drugs and diabetes is coherent with our understanding of diabetes and there are other analogies. However the strength of association is weak, there is lack of consistency or specificity, and there is little evidence to support a biological gradient. We should therefore conclude that the evidence surrounding a causative link between antipsychotic drugs and diabetes is inconclusive. Moreover, the risk is probably low and the attributable risk of developing diabetes is greater for traditional risk factors such as family history, ethnicity, obesity and ageing than it is for receiving an antipsychotic drug. Consequently, the majority of patients receiving second-generation antipsychotics will not develop diabetes as a result of their medication.

show abstract

Testing for diabetes in hospitalised patients prescribed antipsychotic drugs

Cited by 71 publications

References 19 publications

Adherence to metabolic monitoring guidelines in atypical antipsychotic treated subjects: Do physicians comply?

Adherence to metabolic monitoring guidelines in atypical antipsychotic treated subjects: Do physicians comply?

Prevalence of obesity, glucose homeostasis disorders and metabolic syndrome in psychiatric patients taking typical or atypical antipsychotic drugs: a cross-sectional study

Antipsychotic drugs and diabetes—an application of the Austin Bradford Hill criteria

Contact Info

Product

Resources

About