Associatie tussen antipsychoticagebruik en hypoglykemie bij oudere patiënten met diabetes mellitus

OBJECTIVE: To investigate the association between the use of antipsychotic drugs and hypoglycaemia requiring hospital admission in older diabetic patients. DESIGN: Nested case-control study. METHODS: In PHARMO Record Linkage System a cohort of 68.314 patients over 65 years with diabetes was constructed. Cases were patients from the study cohort with a first hospitalization for hypoglycaemia. Up to five controls were selected. Exposure to antipsychotic drugs was the primary determinant of interest. Logistic regression analysis was performed to estimate the strength of association between antipsychotic drug use and hypoglycaemia, taking into account potential confounders. RESULTS: 815 patients were admitted to hospital for hypoglycaemia. Current use of antipsychotic drugs was associated with an increased risk of hypoglycaemia compared with non-use (adjusted odds ratio [OR] 2.27; 95% confidence interval [CI95] 1.46-3.54], especially in the first 30 days of treatment (adjusted OR 7.61; CI95 2.49-23.27). The largest increase in risk was with haloperidol (adjusted OR 2.60; CI95 1.34-5.05] and pipamperone (adjusted OR 2.81; CI95 1.29-6.13]. CONCLUSION: Use of antipsychotic drugs by older patients with diabetes mellitus was associated with an increased risk of hospitalisation for hypoglycaemia. The risk was highest in the first 30 days of treatment.