Diabetic ketoacidosis and olanzapine: Case report and literature review

Rebecca Renata Lapenda Do Monte; Renata Carneiro Melo; Thayane Rego Dantas; Rocha Maria Laura Fontoura Chagas; Ana Beatriz Muniz Costa; Leonardo França Magalhães; Larissa Bastos Pimentel; Amália Cinhtia Meneses Rêgo; Irami Araújo-Filho

doi:10.30574/gscbps.2019.9.3.0216

Authors

Rebecca Renata Lapenda Do Monte Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Renata Carneiro Melo Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Thayane Rego Dantas Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Rocha Maria Laura Fontoura Chagas Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Ana Beatriz Muniz Costa Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Leonardo França Magalhães Undergraduate Student of Medicine at UnP - Potiguar University - Laureate International Universities – Natal/Brazil.
Larissa Bastos Pimentel Endocrinologist and Professor of the Medical Undergraduate Course - Potiguar University - Laureate International Universities – Natal/Brazil.Endocrinologist and Professor of the Medical Undergraduate Course - Potiguar University - Laureate International Universities – Natal/Brazil.
Amália Cinhtia Meneses Rêgo Postgraduate Program in Biotechnology at Potiguar University/ UnP - Laureate International Universities – Natal/Brazil. Ph.D. in Health Science.
Irami Araújo-Filho Postgraduate Program in Biotechnology at Potiguar University/ UnP - Laureate International Universities – Natal/Brazil. Ph.D. in Health Science.

DOI:

https://doi.org/10.30574/gscbps.2019.9.3.0216

Keywords:

Diabetes mellitus, Diabetic ketoacidosis, Psychotic disorders, Antipsychotics, Olanzapine, Adverse drug event

Abstract

The use of antipsychotics (AP) is associated with the development of metabolic disorders, such as diabetic ketoacidosis (DKA) and acute dysregulation of glucose metabolism. Hyperglycemic complications from drug use, although rare, are potentially life-threatening, so appropriate follow-up and risk assessment during treatment are necessary. This study reports the case of a patient with bipolar affective disorder using olanzapine who developed severe DKA and reviews the current literature on this association. The research was done in PubMed, Cochrane Database, Scopus, Web of Science, Embase, and Google Scholar databases using the keywords: diabetes mellitus, diabetic ketoacidosis, psychotic disorders, antipsychotics, olanzapine, adverse drug event. Upon analysis of the included epidemiological studies, it was observed that most patients who developed DKA were undergoing treatment with olanzapine and clozapine alone or in combination with other antipsychotics. It was seen that the DKA picture usually occurs between six to twelve months of AP use, similar to the case presented. Before insulin resistance, male gender, and middle age favor the disorder in AP users.

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