Insulin secretion in patients receiving clozapine, olanzapine, quetiapine and risperidone

Peter Manu*, Christoph U. Correll, Martien Wampers, Ruud van Winkel, Weiping Yu, Daphna Shiffeldrim, John M. Kane, Marc De Hert

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

18 Citations (Web of Science)

Abstract

Second-generation antipsychotics (SGAs) increase the risk of type 2 diabetes. The mechanism is thought to center on drug-induced weight gain, which starts the dysmetabolic cascade of insulin resistance, increased insulin production and pancreatic beta-cell failure. An independent effect of SGAs on insulin secretion has been suggested in animal models, but has not been demonstrated in clinical samples.To determine the post-challenge insulin secretion in patients treated with SGAs.We identified 520 non-diabetic individuals treated with clozapine (N=73), olanzapine (N=190), quetiapine (N=91) or risperidone (N=166) in a consecutive, single-site cohort of 783 adult psychiatric inpatients who underwent a comprehensive metabolic assessment. Insulin secretion was measured as the area under the curve (AUC(insulin)) generated by levels recorded at baseline, 30, 60 and 120 min after the intake of 75 g of glucose. The independent predictors of insulin secretion were determined with regression analysis in the entire sample and separately in patients with normal glucose tolerance (NGT) and prediabetes.The post-challenge AUC(insulin) was independently predicted by AUC(glucose), waist circumference, triglyceride levels and younger age (p
Original languageEnglish
Pages (from-to)358-362
JournalSchizophrenia Research
Volume143
Issue number2-3
DOIs
Publication statusPublished - Feb 2013

Keywords

  • Antipsychotics
  • Clozapine
  • Prediabetes
  • Insulin
  • Oral glucose tolerance test

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