Polcwiartek C, et al. - The aim of this study was to explore the correlation between exposure to antipsychotic medication (within 3 months prior to event) and DKA, type 1 diabetes and type 2 diabetes. Analysts further reported related, clinically relevant outcomes. The findings indicated that antipsychotic exposure was correlated with Diabetic ketoacidosis (DKA) and type 2 diabetes in a previously diabetes-naive schizophrenia population. In addition, antipsychotic-associated DKA is relevant not only for psychiatrists but also for other physicians who may manage and admit such patients.

Methods

• Applying a nested case–control study design, Researchers distinguished cases of DKA, type 1 diabetes and type 2 diabetes in a previously diabetes-naive population with schizophrenia in Denmark from 1995 to 2014.
• For this study, cases were matched (by age, sex and year of schizophrenia onset) 1:5 to schizophrenic control individuals who were alive and had not emigrated prior to event.
• They applied conditional logistic regression to compute ORs with 95% CIs.
• Other outcomes included diabetes aetiology of DKA, in-hospital mortality, DKA readmissions and temporal trends of use of insulin and oral glucose-lowering agents.

Results

• They distinguished 28 individuals with DKA, 90 with type 1 diabetes and 2140 with type 2 diabetes out of 29,955 individuals with schizophrenia.
• These were matched to 137, 410 and 9861 individuals in the control group, respectively.
• Evidence showed that antipsychotic exposure was correlated with DKA (OR 2.60; 95% CI 1.06, 6.38) and type 2 diabetes (OR 1.64; 95% CI 1.48, 1.83).
• They observed a trend towards increased risk of type 1 diabetes but remained insignificant (OR 1.38; 95% CI 0.84, 2.29).
• In 8 cases, diabetes aetiology of DKA was type 1 and type 2 in 14 cases, of the remaining six cases of DKA, aetiology could not be determined, as four were fatal within 8 days and for two, no prescriptions for insulin and oral glucose-lowering agents were redeemed.
• They found that out off all DKA cases, six had more than one episode of DKA, and of all type 1 diabetes and type 2 diabetes cases, four and 11, respectively, had at least one episode.
• The data showed that the use of insulin and oral glucose-lowering agents was higher among individuals with DKA relative to those with type 1 diabetes and type 2 diabetes.