A Case of Diabetic Ketoacidosis by Olanzapine

Kim, Sang Heon; Woo, Jungmin

Abstract

We successfully treated a 47 year old male patient who developed diabetes twice and later fell in diabetic ketoacidosis and delirium during the 4 years of olanzapine therapy. For the first 3 months of olanzapine medication the patient gained 14kg and developed diabetes mellitus 3 years later in the maintenance of olanzapine. Fortunately his diabetes was improved after switching his medication to risperidone. 2 months later he remedicated olanzapine by chance and got 15 kg of weight gain. In a year he developed diabetes again and was finally transferred to emergency room due to diabetic ketoacidosis. It was thought that olanzapine played a negative role in the course of patient's diabetes, and it was switched to amisulpride. The result was that blood glucose levels began to be well controlled without any antihyperglycemic agents in 30 days after the complete withdrawal of olanzapine. During a year's follow up after discharge, the patient didn't show any aggravation of psychotic symptoms and any signs of diabetes. He kept his body weight 68 kg which was the same weight when he was discharged from the hospital. This case showed clearly how olanzapine affected the onset and the course of diabetes in a schizophrenic patient. Therefore we report this case with a few olanzapine related considerations.