Endocrine Abstracts

Introduction: Today, atypical antipsychotics offer the advantage of less frequent extrapyramidal effects compared to conventional neuroleptics, but they are associated with weight gain and diabetes mellitus.

Observation: A 31-year-old patient with positive diabetic heredity, followed for schizophrenia on Levomepromazine and Olanzapine. Having revealed his diabetes mellitus by a diabetic cardinal syndrome. Blood glucose= 3g/l. Urine dipstick shows ketonuria at 2 crosses, confirming the diagnosis of diabetic ketosis. Ideal weight, BMI=18 kg/m2 and TDT= 79 cm. The physical examination was unremarkable except for a psychomotor slowdown. The aetiological assessment of the decompensation was strictly negative. The HbA1C on HPLC standardized on DCCT was 20%, a level confirmed on a second sample.

Discussion: Usually, the HbA1C levels observed at the discovery of T1DM are modest. This is explained by the noisy mode of revelation of this disease. However, in this case, the level was unusual, raising the suspicion of antipsychotic-induced T1DM. Indeed, it has been shown that the prevalence of diabetes is 10% in people treated with antipsychotics, 2 to 3 times higher than in a general population matched for age(*).

Conclusion: Drug-induced or drug-aggravated diabetes is a fairly frequent situation in clinical practice, often requiring multidisciplinary management(*): Drug-induced diabetes: four classes at the heart of our clinical practice.12-10-2022.