Association between atypical antipsychotic agents and type 2 diabetes: Review of prospective clinical data

Abstract

Background: Most evidence suggesting an association between schizophrenia, antipsychotic medications and diabetes has been based on retrospective studies not controlled for important confounders. Aims: To compare diabetogenic risk between antipsychotic medications; and to describe the limitations of current prospective data-sets. Method: Systematic review of prospective clinical data. Results: No difference in the incidence of glycaemic abnormalities between placebo cohorts and antipsychotic medication cohorts was identified. No significant difference between any of the antipsychotic medications studied in terms oftheir association with glycaemic abnormalities was identified. Treatment-related weight gain did not appear to increase the risk of developing diabetes. Conclusions: Diabetogenic potential ascribed to atypical antipsychotic drugs, resulting from retrospective studies, may be incorrect. Cohort sizes and incomplete sampling must preclude any definitive conclusions. Long-term, large, comparative prospective trials are needed, along with agreement upon glucose measurement of choice.