Antipsychotic use and risk for hyperglycemia in elderly patients with DM.

摘要

The problem of treatment-emergent hyperglyce-mia or DM in adolescent or adult patients treated with atypical APDs has become a major concern for psychiatrists. In their study, Lipscombe et al extend the scope to elderly patients (mean age, 78 years) with preexistent DM. Their data convincingly show an increased risk for hyperglycemia in different groups of diabetic patients with APDs, thereby adding another risk factor to the use of APDs in this population.Some methodological issues, however, hamper the interpretation of the data. The inclusion criterion of controls is described as follows: "Patients could serve as a control more than once and were eligible to become a case at a later time."No reason for this design are given nor are its advantages or disadvantages discussed.One exclusion criterion was no use of APDs in the preceding year. The possible impact of antipsychotic treatment during one of the previous 77 years is not discussed, nor are data related to this issue presented. The possible role of the somatic and psychiatric condition that led to the prescription of the APDs is not mentioned, nor are their possible implications for the glucose homeo-stasis discussed.