Do Atypical Antipsychotic Agents Trigger Autoimmune Diabetes? : The Endocrinologist

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CME Review Article #6

Do Atypical Antipsychotic Agents Trigger Autoimmune Diabetes?

Nwosu, Benjamin U. MD*; Hardy, Olga T. MD*; Angelescu, Amanda MD*; Soyka, Leslie A. MD*; Lee, Mary M. MD†

Author Information

*Assistant Professor of Pediatric Endocrinology; and †Professor of Pediatric Endocrinology, Division of Pediatric Endocrinology, University of Massachusetts Medical School, Worcester, Massachusetts.

The authors have disclosed that they have no significant relationships with or financial interests in any commercial organizations pertaining to this educational activity.

All staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity.

Lippincott CME Institute has identified and resolved all faculty and staff conflicts of interest regarding this educational activity.

Reprints: Benjamin U. Nwosu, MD, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655. E-mail: [email protected].

Chief Editor's Note:This article is the 6th of 18 that will be published in 2009 for which a total of up to 18 AMA PRA Category 1 Credits™ can be earned. Instructions for how credits can be earned precede the CME Examination at the back of this issue.

The Endocrinologist 19(2):p 85-87, March 2009. | DOI: 10.1097/TEN.0b013e318198b9b8

Abstract

Atypical or second-generation antipsychotic agents, such as aripiprazole and olanzapine, are increasingly used in the management of schizophrenia and bipolar disorders in children. The atypical antipsychotic agents have been associated with the development of hyperglycemia, ketoacidosis, and diabetes. The mechanism of atypical antipsychotic-mediated hyperglycemia is unclear. Most of the published reports have been on individuals at risk for type 2 diabetes. We present the first known cases of the development of diabetes and positive glutamic acid decarboxylase antibodies (suggestive of autoimmune diabetes) in adolescents while on treatment with atypical antipsychotics. The nature of their clinical presentations and the time course of antipsychotic therapy to clinical diagnosis of diabetes make us speculate that atypical antipsychotics may shorten the time course of the development of autoimmune diabetes in predisposed children.

© 2009 Lippincott Williams & Wilkins, Inc.

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