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Atypical antipsychotic-induced diabetes mellitus: an update on epidemiology and postulated mechanisms

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Diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome are rare, but potentially fatal complications of antipsychotic-associated hyperglycaemia. The mechanisms for this remain unclear, but are probably multifactorial. The suggested reasons include drug-induced weight gain and adiposity, development of the metabolic syndrome, antagonism of serotonin (5-hydroxytryptamine) receptors, drug-induced leptin resistance, dyslipidaemia mediated pancreatic -cell damage and hepatocyte transcription factor dysregulation. Patients with schizophrenia are known to be at a higher genetic risk of developing diabetes mellitus and cardiovascular disease. This review emphasizes a rare case of hyperosmolar hyperglycaemic syndrome in a young man with schizophrenia and discusses proposed mechanisms for the development of antipsychotic-associated diabetes mellitus.
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Keywords: atypical antipsychotic; diabetes mellitus; diabetic ketoacidosis; hyperosmolar hyperglycaemic syndrome

Document Type: Research Article

Affiliations: 1: Department of Medicine, Mona Vale Hospital 2: Department of Medicine, Manly General Hospital, Sydney, New South Wales, Australia

Publication date: July 1, 2008

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