Abstract

STUDY OBJECTIVES:

To determine whether the frequency of new-onset diabetes mellitus differs between patients taking atypical antipsychotic agents and those taking typical agents, whether the frequency of new-onset diabetes differs among those taking the atypical antipsychotic agents, and what clinical and demographic factors influence the occurrence of new-onset diabetes.

DESIGN:

Retrospective analysis.

SETTING:

Central Texas Veterans Health Care System.

PATIENTS:

Continuously enrolled adult (> or = 18 yrs) patients with no previous (6 mo) antipsychotic use and no history (previous 1 yr) of diabetes.

MEASUREMENTS AND MAIN RESULTS:

Data from the Central Texas Veterans Health Care System were extracted from September 1995-November 2002. Clinical and demographic factors used in the analysis were antipsychotic agent taken, body mass index, diabetes-related risk factors, type of mental health comorbidity, age, sex, and race. Among those who met the inclusion criteria (3469 patients), chi2 analyses revealed no significant difference in the frequency of diabetes between the typical and atypical groups (p=0.5553) or among those taking atypical agents (p=0.6520). Multivariate logistic regression (1587 patients) revealed that increasing age (odds ratio [OR] 1.213, 95% confidence interval [CI] 1.016-1.447, p=0.0324), nonwhite race (OR 1.761, 95% CI 1.174-2.640, p=0.0062), and hyperlipidemia (OR 1.606, 95% CI 1.064-2.425, p=0.0242) were significantly related to new-onset diabetes.

CONCLUSIONS:

Among veterans taking antipsychotic agents, no difference was noted in the frequency of diabetes between patients who took typical agents and those who took atypical agents. After controlling for demographic and clinical variables, still no significant difference was noted among the agents. The main factors (increasing age, nonwhite race, and hyperlipidemia) related to new-onset diabetes were those that are typically associated with the disease.