0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Antipsychotic Use and Risk for Hyperglycemia in Elderly Patients With DM—Reply

Lorraine L. Lipscombe, MD, MSc; Andrea Gruneir, PhD; Linda E. Levesque, PhD; Sudeep S. Gill, MD, MSc; Paula A. Rochon, MD, MPH
Arch Intern Med. 2009;169(22):2162-2166. doi:10.1001/archinternmed.2009.450.
Text Size: A A A
Published online

Extract

In reply

Hasnain and Vieweg raise some important limitations regarding observational studies such as ours. As stressed in our article,1 we fully agree that our study cannot confirm a causal relationship between APD use and hyperglycemia because of the potential role of unmeasured confounders. However, they also argue that the dramatic difference between first-time and prevalent users contradicts an acute hyperglycemic effect of APDs, which is untrue. Some adverse drug effects may occur early in susceptible individuals. Offending drugs tend to be discontinued in these patients, and these “susceptibles” are depleted from the population leaving lower-risk “prevalent” users.2,3 The absolute risk of an acute effect may be low because there may be relatively few susceptible individuals, but their risk would be higher relative to less vulnerable patients. Because we found significant risks among both first-time and prevalent users, our study suggests that APDs can have both acute and chronic metabolic effects. While our study cannot prove a direct effect of antipsychotic agents on hyperglycemia, it indicates that the initiation of an APD represents a critical period during which diabetic patients are particularly vulnerable to serious glycemic deterioration.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();