Is Ketoacidosis The Same As Hyperglycemia

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Hyperglycemia Associated With Olanzapine Treatment

Sir, Olanzapine is an atypical antipsychotic that has been widely used because of its better clinical efficacy, superior activity against negative symptoms, lesser extra-pyramidal symptoms, and better tolerability profile compared to typical antipsychotics. Recently, a flurry of reports have stated that olanzapine is associated with high blood sugar levels in new onset or pre-existing diabetes mellitus and ketoacidosis,[1–4] which may be reversible after discontinuation of olanzapine. The exact cause of glucose dysregulation by olanzapine is not clear. It has been hypothesized that 5-HT1 antagonism may decrease the responsiveness of the pancreatic beta cells, thus reducing the secretion of insulin and causing hyperglycemia.[5] In vivo studies suggest that olanzapine impairs glycogen synthesis via inhibition of the classical insulin signaling cascade and this inhibitory effect may lead to the induction of insulin resistance in olanzapine-treated patients. Koller and Doraiswamy[6] reported 188 new-onset diabetes out of 237 cases, which had no previous history of diabetes mellitus. Olanzapine can cause fatal outcome like diabetic ketoacidosis that may lead to death. Same authors rep Continue reading >>

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