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Screening for diabetes using monitoring guidance in schizophrenia patients treated with second-generation antipsychotics: A 1-year follow-up study.
MedLine Citation:
PMID:  21807061     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Second-generation antipsychotics (SGAs) tend to induce weight gain, dyslipidemia and diabetes mellitus. For those reasons, patients treated with SGAs should receive appropriate monitoring to avoid morbidity and mortality associated with cardiovascular disease. We conducted a one-year follow-up study using Japanese blood glucose monitoring guidance in schizophrenia patients treated with SGAs to evaluate the detection capability of the guidance in real clinical settings and to assess the importance of longitudinal monitoring. This retrospective cohort study included schizophrenia patients receiving at least one SGA, who were enrolled during June 2008-January 2009 at multiple sites and who had both baseline data and follow-up monitoring data at month 12. After one-year follow-up, the probable diabetes type (fasting blood glucose is higher than 125mg/dL, casual blood glucose is higher than 179mg/dL, or glycosylated hemoglobin (Hb(A1c)) is greater than 6.4%) was detected in 30 (8%) of the patients, and the pre-diabetes type (fasting blood glucose is 110-125mg/dL, or casual blood glucose is 140-179mg/dL, or Hb(A1c) is 6.0-6.4%) in 65 (17.4%) out of the total of 374 patients. During the follow-up period, 1.5% of patients had advanced from the normal (fasting blood glucose is less than 110mg/dL, casual blood glucose is less than 140mg/dL, or Hb(A1c) is less than 6.0%) to probable diabetes type and 42.4% had progressed from the pre-diabetes to probable diabetes type. Predictive factors for worsening of the diabetic state were a family history of diabetes, and high serum total-cholesterol and triglyceride levels at baseline. Not only cross-sectional baseline screening but also longitudinal follow-up screening is important to detect glucose abnormalities in patients treated with SGAs.
Authors:
Ichiro Kusumi; Koki Ito; Keiichi Uemura; Minoru Honda; Tadayuki Hayashishita; Kazuko Miyamoto; Hiroyuki Sawayama; Yuki Kako; Shoichiro Tsuchida; Naoki Hashimoto; Tsukasa Koyama
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-7-23
Journal Detail:
Title:  Progress in neuro-psychopharmacology & biological psychiatry     Volume:  -     ISSN:  1878-4216     ISO Abbreviation:  -     Publication Date:  2011 Jul 
Date Detail:
Created Date:  2011-8-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8211617     Medline TA:  Prog Neuropsychopharmacol Biol Psychiatry     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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