ESPE Abstracts (2014) 82 P-D-1-1-66

Metabolic Consequences of Antipsychotic Medication in Youths with Type 1 Diabetes: Analysis from the Prospective Nationwide German and Austrian Diabetes Survey DPV

Angela Gallera, Esther Molzb, Michael Meusersc, Bela Bartusd, Andrea Näkee, Holger Haberlandf, Edith Schoberg & Reinhard W Hollb


aCharité - Universitätsmedizin Berlin, Berlin, Germany; bInstitute of Epidemiology and Medical Biometry, University Ulm, Ulm, Germany; cGemeinschaftskrankenhaus Herdecke, Child and
Adolescent Psychiatry, Herdecke, Germany; dFilderklinik,
Filderstadt, Germany; eUniversity Carl Gustav Carus Dresden, University Hospital for Children and Adolescents, Dresden, Germany; fSana Hospital Berlin Lindenhof, Hospital for Children and Adolescents, Berlin, Germany; gMedical University Vienna, University Hospital for Children and Adolescents, Vienna, Austria


Background: The use of antipsychotic medication in medical practice is increasing in Europe. Antipsychotics have serious adverse effects like weight gain.

Objective: Aim was to explore metabolic risk factors and glycaemic control in youths with type 1 diabetes treated with typical or atypical antipsychotics.

Design and methods: Data of children, adolescents, and young adults with type 1 diabetes up to the age of 25 years and with diabetes duration of more than 6 months registered in the prospective, nationwide German/Austrian computer-based diabetes survey (DPV) were included in the analysis. BMI SDS, HbA1c, prevalences of dyslipidaemia, microalbuminuria, and retinopathy, and frequencies of hypoglycaemia and diabetic ketoacidosis (DKA) in subjects treated with typical or atypical antipsychotics were compared to those without antipsychotic medication and analysed by regression analysis.

Results: A total of 291 patients with type 1 diabetes (age 17 years, 60% males, diabetes duration 7.2 years) received antipsychotic medication (most commonly risperidone). Subjects treated with antipsychotics had a significant higher BMI SDS (P=0.004) and dyslipidaemia was more frequent (P=0.045) compared to subjects without antipsychotic medication. Frequencies of severe hypoglycaemias and DKA were significantly higher in patients receiving antipsychotics (P<0.001). Prevalences of microalbuminuria, and retinopathy were not different. In subjects treated with antipsychotics, glycaemic control did not differ compared to patients without antipsychotic medication.

Conclusions: This analysis demonstrated that treatment with antipsychotic medication was associated with higher BMI SDS and higher rates of acute diabetic complications in youths with type 1 diabetes.