Diabetes Mellitus Among Outpatients Receiving Clozapine: Prevalence and Clinical-Demographic Correlates
J Clin Psychiatry 2005;66(7):900-906
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Background: Treatment with antipsychotic drugs
has been associated with increased risk for developing diabetes
mellitus. Recent consensus statements suggest that clozapine may
pose an especially high risk. The purpose of this study is to
examine the prevalence and clinical-demographic correlates of
diabetes among outpatients with DSM-IV-diagnosed schizophrenia or
schizoaffective disorder receiving clozapine.
Method: One hundred one outpatients receiving
clozapine at the University of Rochester Department of
Psychiatry, Rochester, N.Y., were evaluated between September
2002 and September 2003. Demographic data were collected from
medical records, and body mass index (BMI) and body fat
measurements were conducted. Diagnosis of diabetes was
established through review of medical records and fasting blood
glucose testing. Associations between clinical and demographic
variables and diabetes were examined using t tests, Fisher exact
tests, and logistic regression.
Results: Mean (SD) age of patients was 40.4
(9.5) years, and 79% were white. Mean (SD) dose and duration of
clozapine treatment were 426 (164) mg/day and 5.7 (3.6) years,
respectively. Point prevalence of diabetes was 25.7%. Mean (SD)
BMI was 32.6 (8.0) kg/m2, and mean (SD) body fat was
34.0% (11.0%). Logistic regression revealed significant
associations between diabetes and nonwhite race/ethnicity and
family history of diabetes (p = .02 and .002, respectively). No
significant associations were found between diabetes prevalence
and BMI or body fat.
Conclusion: Patients receiving clozapine are at
substantial risk for developing diabetes, although the level of
risk relative to other antipsychotic medications has not been
fully determined. Clinicians should monitor all severely mentally
ill patients receiving antipsychotic drugs for diabetes, with
closer monitoring of patients with established demographic risk