Insulin Resistance One Mechanism Two Presentations: Olanzapine Induced DKA and Hypertriglyceridemia

Louis Costanzo^1, , Chetana Pendkar¹, Amara Shafi¹ and Joseph Gorga²

¹Department of Internal Medicine, State University of New York, Downstate- Health Science University, Brooklyn, NY, USA - 11203

²Division of Pulmonology, State University of New York, Downstate- Health Science University, Brooklyn, NY, USA - 11203

Cite this paper:
Louis Costanzo, Chetana Pendkar, Amara Shafi and Joseph Gorga. Insulin Resistance One Mechanism Two Presentations: Olanzapine Induced DKA and Hypertriglyceridemia. American Journal of Medical Case Reports. 2021; 9(2):131-133. doi: 10.12691/ajmcr-9-2-8

Abstract

Patients taking antipsychotic medications have a well-established increased risk of developing metabolic syndrome. These medications interfere with an intracellular signaling pathway leading to insulin resistance; that of which can lead to dangerous complications including diabetic ketoacidosis (DKA) and severe hypertriglyceridemia. We report a case of a 21-year-old man who developed DKA and severe hypertriglyceridemia secondary to the use of olanzapine used for the management of schizophrenia.

Keywords:
atypical antipsychotics critical care diabetic ketoacidosis hypertriglyceridemia insulin resistance metabolic acidosis olanzapine

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References:

[1]	Uçok A, Gaebel W. Side effects of atypical antipsychotics: a brief overview. World Psychiatry. 2008; 7(1): 58-62.
[2]	Ball MP, Coons VB, Buchanan RW. A program for treating olanzapine-related weight gain. Psychiatr Serv. 2001; 52: 967-969.
[3]	Hirowatari Y, Yoshida H, Kurosawa H, Doumitu KI, Tada N. Measurement of cholesterol of major serum lipoprotein classes by anion-exchange HPLC with perchlorate ion-containing eluent. J Lipid Res. 2003; 44(7): 1404-1412.
[4]	Wilson DR, D'Souza L, Sarkar N, Newton M, Hammond C. New-onset diabetes and ketoacidosis with atypical antipsychotics. Schizophr Res. 2003; 59: 1-6.
[5]	De Meyts P. The Insulin Receptor and Its Signal Transduction Network. [Updated 2016 Apr 27]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK378978/.
[6]	Atmaca M, Kuloglu M, Tezcan E, Ustundag B. Serum leptin and triglyceride levels in patients on treatment with atypical antipsychotics. J Clin Psychiatry. 2003; 64(5): 598-604.
[7]	Weston-GreenK, Huang XF, Lian J, Deng C. Effects of olanzapine on muscarinic M3 receptor binding density in the brain relates to weight gain, plasma insulin and metabolic hormone levels.Eur Neuropsychopharmacol. 2012; 22(5): 364-73.
[8]	Thomas K, Saadabadi A. Olanzapine. [Updated 2020 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532903/.
[9]	Generali JA, Cada DJ. Topiramate: antipsychotic-induced weight gain. Hosp Pharm. 2014; 49(4): 345-347.
[10]	Praharaj SK, Sharma PS. Amantadine for olanzapine-induced weight gain: a systematic review and meta-analysis of randomized placebo-controlled trials. Ther Adv Psychopharmacol. 2012; 2(4): 151-156.
[11]	van der Zwaal EM, Janhunen SK, Luijendijk MC, et al. Olanzapine and sibutramine have opposing effects on the motivation for palatable food. Behav Pharmacol. 2012; 23(2): 198-204.