Olanzapine-associated severe hyperglycemia, ketonuria, and acidosis: case report and review of literature.

Abstract:

:Olanzapine has been associated with insulin resistance and new-onset diabetes mellitus. A 27-year-old African-American man developed new-onset severe hyperglycemia-glucose 1240 mg/dl, with ketonuria and acidosis, but no weight gain-2 years after starting olanzapine. Although his diabetes was stabilized with insulin, his family had difficulty monitoring his therapy, and insulin was discontinued. Subsequent monotherapy with pioglitazone stabilized the patient's glucose levels, allowing him to continue taking olanzapine. Health care professionals should be aware of links between olanzapine and diabetes mellitus and of the potential for delayed recognition of complications associated with diabetes in patients who are psychotic. Insulin poses additional problems because families of patients with schizophrenia have to deal with compliance and risk of accidental or suicidal overdose. This case and others described in the literature illustrate such dilemmas and highlight the need to further study links connecting diabetes, insulin resistance, and olanzapine. Further research to determine proportionality and risk differences among various atypical antipsychotics also is warranted.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Seaburg HL,McLendon BM,Doraiswamy PM

doi

10.1592/phco.21.17.1448.34421

subject

Has Abstract

pub_date

2001-11-01 00:00:00

pages

1448-54

issue

11

eissn

0277-0008

issn

1875-9114

journal_volume

21

pub_type

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