Testing for diabetes

L. Citrome, A. Jaffe and J. Levine

New York University School of Medicine, Department of Psychiatry, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg NY10962, USA

Declaration of interest

L.C. has received research support and/or honoraria for speaking on advisory boards from Abbott, Astra Zeneca, Bristol Myers Squibb, Eli Lilly, Janssen, Novartis, Pfizer and Repligen Corp. A.J. has received research support from Eli Lilly.

Taylor et al (2004) report on the differences in testing for diabetes among 606 patients receiving antipsychotics, observing that patients receiving atypical antipsychotics were more likely to have been tested than those receiving older agents. Moreover, this appeared to be significant specifically for clozapine, olanzapine, and antipsychotic polypharmacy.

It is noteworthy that very similar results were found by our group when examining hospitalised patients in New York State (Citrome et al, 2003, 2004). Among 1154 patients in 2000–2002 with no known prior history of receiving antidiabetic medications, those receiving clozapine, olanzapine, or more than one atypical antipsychotic had a significantly higher frequency of blood glucose testing than those receiving only typical antipsychotics (Citrome et al, 2004). Moreover, those receiving risperidone had a frequency of testing similar to those receiving only older agents, resulting in the conclusion that there are clear differences in surveillance for diabetes mellitus among even the newer agents.

Investigators performing pharmaco-epidemiological studies examining the risk of association between antipsychotics and diabetes mellitus need to be mindful of this surveillance bias.

REFERENCES

Citrome, L., Jaffe, A., Levine, J., et al (2003) Antipsychotic medication treatment and new prescriptions for insulin and oral hypoglycaemics. European Neuropsychopharmacology, 13 (suppl. 4), S306.

Citrome, L., Jaffe, A., Levine, J., et al (2004) Relationship between antipsychotic medication treatment and new cases of diabetes among psychiatric inpatients. Psychiatric Services, 55, 1006 -1013.[Abstract/Free Full Text]

Taylor, D., Young, C., Esop, R., et al (2004) Testing for diabetes in hospitalised patients prescribed antipsychotic drugs. British Journal of Psychiatry, 185, 152 -156.[Abstract/Free Full Text]





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