Exposure to Second-Generation Antipsychotics and Risk of Type 2 Diabetes Mellitus in Adolescents and Young Adults: A Nationwide Study in Taiwan

Background: The association between second-generation antipsychotics (SGAs) and type 2 diabetes mellitus (T2DM) has been well investigated in adults. However, T2DM risk has been less examined among adolescents with SGA exposure, and the risk remains uncertain in this population.

Methods: A total of 91,185 adolescents and young adults within the Taiwan National Health Insurance system who were exposed to SGAs were enrolled into this study between 2000 and 2011.The patients were divided into 4 subgroups on the basis of cumulative defined daily doses (cDDDs) of SGAs taken by them in the study period: < 30 cDDDs, 30-179 cDDDs, 180-364 cDDDs, and ≥ 365 cDDDs. Those who developed T2DM (ICD-9-CM) during follow-up, which was the period from enrollment to the end of 2011, were identified.

Results: Compared with those in the < 30 cDDD group, adolescents and young adults in the 30-179, 180-364, and ≥ 365 cDDD groups exhibited a high risk of T2DM in later life that increased dose dependently (hazard ratio [HR] = 1.15, 95% CI, 0.98-1.34; HR = 1.54, 95% CI, 1.28-1.84; HR = 1.91, 95% CI, 1.67-2.18, respectively) after adjustment for demographic data, medical comorbidities, and psychiatric disorders.

Discussion: Our study results showed a significant relationship between SGA exposure and T2DM risk among adolescents and young adults. These results raise further concern about the use of SGAs in pediatric populations, and on the basis of these results, clinicians should monitor the metabolic condition of their patients.