Antipsychotic drugs have significant risks for seniors with diabetes

27/07/2009

Antipsychotic medication is associated with a higher risk of hospitalization for high blood sugar (hyperglycemia) in seniors with diabetes according to a study led by researchers at the Institute for Clinical Evaluative Sciences (ICES) and Women’s College Research Institute at Women’s College Hospital. And despite several recent warnings of higher risk of stroke and mortality, antipsychotic drugs, usually recommended for patients with schizophrenia, continue to be used to control behavioral symptoms of dementia.

The study, to be published in the July 27 issue of Archives of Internal Medicine, found seniors with diabetes who were newly treated with an antipsychotic medication were 50 per cent more likely to be hospitalized for hyperglycemia compared to those who were not taking the drug. The greatest risk appeared to be right after the first prescription for an antipsychotic, at which time there was a 6 to 15-fold rise in hospitalizations for high blood sugar.

“This indicates that patients with diabetes are more vulnerable to sudden worsening of their glucose control during the initiation of antipsychotic drugs,” says principal investigator Dr. Lorraine Lipscombe, who is also a scientist at ICES and Women's College Research Institute. “This is particularly significant for the elderly because they are the biggest group of patients with diabetes, and are already the most vulnerable to poor diabetes control.”

The study looked at 13,817 patients in Ontario, 66 years of age or older with diabetes who started antipsychotic treatment between April 1, 2002 and March 31, 2006.

“Our findings suggest that options other than antipsychotic drugs should be considered for seniors with diabetes who have behavioral symptoms of dementia,” says Dr. Lipscombe. “If antipsychotic drugs are to be used, patients and families should pay close attention to signs of deterioration in glucose control, and be more vigilant about glucose monitoring.” This research focused on whether antipsychotic drugs increase the risk of hyperglycemia in patients with diabetes, though further research is needed to determine if the drugs increase the risk of developing diabetes for those who don’t yet have the disease.

The study was supported by funding from the Canadian Institutes for Health Research.

About the Institute for Clinical Evaluative Sciences

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

About Women’s College Research Institute
Women’s College Hospital has established Canada’s largest research institute dedicated solely to generating knowledge about women’s health. Called the Women’s College Research Institute (WCRI), it is leading the charge in breakthrough research and charting the path globally in new developments.

Over the past decade, WCRI’s work has had a substantial impact worldwide. Breech births are safer because of its research. Women’s College Hospital is a world leader in understanding the genetics of breast and ovarian cancers. And it is now possible to identify the potential for osteoporosis in young women.

Today, as Canada’s only facility that tests women’s healthcare innovations within an ambulatory care community, WCRI continues to forge new ground as it focuses on key areas of women’s health and sex- and gender-based medicine: women and violence, mental health, genetics and cancer, obstetrics, osteoporosis, diabetes, and HIV/AIDS.