Manejo farmacológico de la hiperglucemia asociada a antipsicóticos atípicos en pacientes diabéticos con esquizofrenia: una revisión sistemática

Abstract

Background: Diabetes mellitus represents one of the leading causes of death worldwide, related to various factors: genetics, environmental, inappropriate lifestyle and adverse effects associated with the consumption of certain drugs. Atypical antipsychotics are known to cause drug-induced diabetes, especially in vulnerable populations such as people with schizophrenia. Aim: To define the most appropriate pharmacological management of hyperglycemia associated with atypical antipsychotics in diabetic patients with schizophrenia. Methodology: The present study consists of a qualitative systematic review of clinical trials about the management of hyperglycemia associated with atypical antipsychotics in diabetic patients with schizophrenia. The articles were obtained by applying the previously determined search equation and inclusion and exclusion criteria. Results: 346 studies were obtained using the default search equation. 6 clinical trials were selected based on the inclusion and exclusion criteria, of which 3 qualify as “high quality of evidence” and determine that metformin and adjuvants such as melatonin and lipoic acid are useful for the management of hyperglycemia; 2 are of moderate quality and 1 of low quality. Conclusions: Medications can be implemented as adjuvants in the management of hyperglycemia due to the consumption of atypical antipsychotics in diabetic patients with schizophrenia, among the most recommended is metformin, which in addition to its hypoglycemic effect, causes weight loss, increases HDL cholesterol, and improves insulin resistance.