Screening for diabetes using Japanese monitoring guidance in schizophrenia patients treated with second‐generation antipsychotics: A cross‐sectional study using baseline data

• Published in: Psychiatry and clinical neurosciences 2011-06, Vol.65 (4), p.349-355
• Main Authors: Kusumi, Ichiro, Ito, Koki, Honda, Minoru, Hayashishita, Tadayuki, Uemura, Keiichi, Hashimoto, Naoki, Murasaki, Mitsukuni, Atsumi, Yoshihito, Kadowaki, Takashi, Koyama, Tsukasa
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Antipsychotic Agents - adverse effects; Antipsychotic Agents - therapeutic use; Asian Continental Ancestry Group; Biological and medical sciences; Blood; Blood Glucose; Blood Glucose Self-Monitoring; Body mass index; Cross-Sectional Studies; Data processing; Diabetes mellitus; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - etiology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fasting; Female; Glucose; glucose monitoring guidance; Glycated Hemoglobin A; Hospitals; Humans; Hyperglycemia; Male; medical records; Medical sciences; Mental disorders; metabolic abnormality; Middle Aged; Neuroleptics; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychoses; Schizophrenia; Schizophrenia - complications; Schizophrenia - drug therapy; second‐generation antipsychotic; Serum lipids
• ISSN: 1323-1316; 1440-1819
• DOI: 10.1111/j.1440-1819.2011.02218.x

Aim:  The Japanese blood glucose monitoring guidance for patients receiving second‐generation antipsychotics has been newly developed. We aimed to report a cross‐sectional study using the baseline data of the Japanese monitoring guidance to find undiagnosed hyperglycemia systematically as a routine clinical practice and to quantify the frequency of glucose abnormalities in schizophrenia patients treated with second‐generation antipsychotics. Methods:  Data for 537 patients with schizophrenia, who had not been diagnosed as having diabetes prior to baseline screening and started the monitoring between June 2008 and January 2009, were collected from medical records in 25 hospitals. Blood glucose (fasting or casual), hemoglobinA1c, serum lipids, height/weight, clinical diabetic symptoms, and family history of diabetes were assessed. Patients were classified into normal, pre‐diabetic or probable diabetic type based on their values of blood glucose or hemoglobinA1c, and various background characteristics and serum lipid values were compared among the three types. Results:  Out of 537 patients, 13 (2.4%) met criteria for probable diabetic type, 51 (9.5%) for pre‐diabetic type, and 473 (88.1%) for normal type. Individuals categorized as probable diabetic type had a higher body mass index and higher frequency of family history of diabetes mellitus than those with normal type. Conclusion:  Glucose abnormalities were newly detected in 11.9% of schizophrenia patients treated with second‐generation antipsychotics by the baseline monitoring. To assess the detective power and usefulness of the guidance, longitudinal investigations are necessary.