Mahyar Etminan1, David L Streiner, Paula A Rochon. 1. Department of Clinical Epidemiology, Royal Victoria Hospital, McGill University, Montreal, Quebec, Canada. Mahyar.etminan@mail.mcgill.ca
Abstract
STUDY OBJECTIVE: To explore the suggested association between atypical neuroleptic use and the development of diabetes mellitus, with a focus on older adults. DESIGN: Retrospective cohort study. SUBJECTS: Eleven thousand one hundred four older (> 65 yrs) residents of long-term care institutions in Ontario, Canada, who received either atypical neuroleptic agents, typical neuroleptic agents, benzodiazepines, or corticosteroids. MEASUREMENTS AND MAIN RESULTS: Each subject was followed for the development of a diabetic event, defined as newly prescribed antidiabetic drug therapy. Our Cox regression model was adjusted for age, sex, socioeconomic status, comorbidity, and concomitant use of beta-blockers, thiazide diuretics, and antiepileptic agents. The adjusted hazard ratio for the development of diabetes in patients receiving atypical neuroleptics compared with those receiving benzodiazepines (control group) was 0.89 (95% confidence interval [CI] 0.66-1.21). The adjusted hazard ratio for typical neuroleptic users compared with the benzodiazepine group was 1.27 (95% CI 0.91-1.77). As expected, patients receiving corticosteroid therapy were almost twice as likely to develop diabetes as those receiving benzodiazepines (adjusted hazard ratio 2.2, 95% CI 1.41-3.12). For patients receiving atypical neuroleptic agents, no statistically significant difference in the percentage of diabetic events was found among individual agents (2.1% olanzapine, 1% quetiapine, 2.1% risperidone). CONCLUSION: Drug therapy with atypical neuroleptic agents in older adults did not increase their risk of developing diabetes mellitus.
STUDY OBJECTIVE: To explore the suggested association between atypical neuroleptic use and the development of diabetes mellitus, with a focus on older adults. DESIGN: Retrospective cohort study. SUBJECTS: Eleven thousand one hundred four older (> 65 yrs) residents of long-term care institutions in Ontario, Canada, who received either atypical neuroleptic agents, typical neuroleptic agents, benzodiazepines, or corticosteroids. MEASUREMENTS AND MAIN RESULTS: Each subject was followed for the development of a diabetic event, defined as newly prescribed antidiabetic drug therapy. Our Cox regression model was adjusted for age, sex, socioeconomic status, comorbidity, and concomitant use of beta-blockers, thiazide diuretics, and antiepileptic agents. The adjusted hazard ratio for the development of diabetes in patients receiving atypical neuroleptics compared with those receiving benzodiazepines (control group) was 0.89 (95% confidence interval [CI] 0.66-1.21). The adjusted hazard ratio for typical neuroleptic users compared with the benzodiazepine group was 1.27 (95% CI 0.91-1.77). As expected, patients receiving corticosteroid therapy were almost twice as likely to develop diabetes as those receiving benzodiazepines (adjusted hazard ratio 2.2, 95% CI 1.41-3.12). For patients receiving atypical neuroleptic agents, no statistically significant difference in the percentage of diabetic events was found among individual agents (2.1% olanzapine, 1% quetiapine, 2.1% risperidone). CONCLUSION: Drug therapy with atypical neuroleptic agents in older adults did not increase their risk of developing diabetes mellitus.
Authors: Almut G Winterstein; Paul Kubilis; Steve Bird; Rhonda M Cooper-DeHoff; Greg A Nichols; Joseph A Delaney Journal: Pharmacoepidemiol Drug Saf Date: 2014-06-12 Impact factor: 2.890
Authors: Eric J Lenze; Meera Sheffrin; Henry C Driscoll; Benoit H Mulsant; Bruce G Pollock; Mary Amanda Dew; Frank Lotrich; Bernie Devlin; Robert Bies; Charles F Reynolds Journal: Dialogues Clin Neurosci Date: 2008 Impact factor: 5.986