Reference : Diabete sucre iatrogene: l'exemple des anti-psychotiques atypiques.
Scientific journals : Article
Human health sciences : Psychiatry
Human health sciences : Endocrinology, metabolism & nutrition
Diabete sucre iatrogene: l'exemple des anti-psychotiques atypiques.
[en] Drug-induced diabetes mellitus: the exemple of atypical antipsychotics
Scheen, André mailto [Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
De Hert, M. [> > > >]
Revue Médicale de Liège
Le diabète sucré dans tous ses états
Yes (verified by ORBi)
[en] Antipsychotic Agents/adverse effects/therapeutic use ; Diabetes Mellitus/chemically induced ; Humans ; Iatrogenic Disease ; Insulin/secretion ; Insulin Resistance ; Pancreatitis ; Risk Factors ; Weight Gain
[en] As an example of iatrogenic diabetes, we discuss the problem of diabetes mellitus in patients receiving atypical antipsychotics. The risk of diabetes mellitus appears to be different according to various molecules with, by decreasing order, clozapine, olanzapine, risperidone and quetiapine, and finally amisulpride, aripiprazole and ziprasidone. A careful analysis of published case reports and series indicates the existence of two different problems: 1) the rather common development of impaired glucose tolerance or diabetes mellitus (often associated with metabolic syndrome) related to weight gain in individuals at risk for type 2 diabetes; and 2) the occurrence of rare cases of acute metabolic episodes with severe ketoacidosis and/or pancreatitis whose pathophysiological mechanisms remain largely unknown. Generally speaking, the pathophysiology involves both increased insulin resistance and deficient insulin secretion. Cautious metabolic monitoring of patients receiving atypical antipsychotics is recommended, and the selection of the appropriate drug should be influenced by the metabolic profile of the various molecules and the metabolic risk of the patients who should be treated with atypical antipsychotics.
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