Session number: 1125
Abstract title: Occult Hyperglycemia and Diabetes Mellitus in Clozapine-Treated Patients
Author(s):
MJ Sernyak - VA Connecticut/ Yale University
B Gulanski - VA Connecticut/ Yale University
DA Leslie - NEPEC/ Yale University
R Rosenheck - NEPEC/ Yale University
Objectives: Clozapine has been demonstrated to be superior to typical neuroleptics in reducing refractory symptoms in patients with schizophrenia, but it has also been associated with hyperglycemia and diabetes mellitus. This study was designed to investigate the rate of undiagnosed hyperglycemia and diabetes mellitus in patients prescribed clozapine at 8 Department of Veterans Affairs (VA) medical centers
Methods: All patients treated by the VA in New England diagnosed with schizophrenia who received a prescription for clozapine were identified and an attempt was made to obtain a fasting blood sugar screening (FBS) test. All patients were also characterized as to whether they were diagnosed as diabetic prior to the screening FBS. Among the group not previously diagnosed as diabetic, patients were divided into those with normal FBS (<110 mg/dl) and those with elevated FBS (>= 110 mg/dl). Clinical and socio-demographic characteristics of the two groups were compared using chi-square and t-tests.
Results: Overall 121 patients were not previously diagnosed as diabetic and received an FBS. Ninety-three (77%) had a normal FBS, and 28 (23%) had an elevated fasting blood sugar. Patients with elevated FBS were significantly older and more commonly co-diagnosed with bipolar disorder.
Conclusions: Elevated FBS results were common in patients receiving clozapine who had not been previously diagnosed as diabetic.
Impact statement: This study supports the assertion that clozapine-treated patients with schizophrenia should be considered a group at high-risk to develop diabetes mellitus and deserve both close monitoring and early intervention at the first sign of the onset of either diabetes or impaired glucose tolerance.