Excessive use of antipsychotics as a global problem of clinical medicine

2020 ◽  
pp. 9-16
Author(s):  
Yuriy Sivolap ◽  
Anna Portnova
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Antipsychotic Drugs ◽  
Clinical Medicine ◽  
Metabolic Effects ◽  
Antipsychotic Therapy ◽  
Off Label ◽  
The World

In recent decades in many regions of the world there has been an increase in prescribing antipsychotics, including for children and adolescents, and in many cases the drugs are used off label, in patients without diagnosis of schizophrenia and other psychoses and bipolar disorder or — in child and adolescent practice — without severe behavioral disorders. In addition, antipsychotics are often prescribed at excessive doses, and antipsychotic therapy is not accompanied by proper monitoring of physiological functions and laboratory parameters. The metabolic effects of antipsychotics contribute to weight gain, obesity and metabolic syndrome, increase the risk of type 2 diabetes, as well as cardiovascular diseases development. Children and adolescents, as well as young adults, are particularly vulnerable to the undesirable metabolic effects of antipsychotic drugs. The deterioration of physical health due to side effects of antipsychotics is one of the reasons for reducing life expectancy in patients with mental disorders.

scholarly journals Current and Future Treatment of Metabolic Syndrome and Type 2 Diabetes in Children and Adolescents

2005 ◽  
Vol 18 (4) ◽  
pp. 220-228 ◽  
Author(s):  
J. T. Mallare ◽  
A. H. Karabell ◽  
P. Velasquez-Mieyer ◽  
S. R.S. Stender ◽  
M. L. Christensen
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Children And Adolescents ◽  
Future Treatment

scholarly journals Metabolic Effects of Testosterone Replacement Therapy in Patients with Type 2 Diabetes Mellitus or Metabolic Syndrome: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Shu-ying Li ◽  
Ya-ling Zhao ◽  
Yu-fan Yang ◽  
Xi Wang ◽  
Min Nie ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Body Weight ◽  
Insulin Sensitivity ◽  
Meta Analysis ◽  
Metabolic Effects ◽  
Testosterone Replacement Therapy

Background. Testosterone replacement therapy (TRT) is commonly used for the treatment of hypogonadism in men, which is often associated with type 2 diabetes mellitus (T2DM) and metabolic syndrome (Mets). Recent compiling evidence shows that TRT has beneficial metabolic effects on these patients. Objective. A meta-analysis has been conducted to evaluate the effects of TRT on cardiovascular metabolic factors. Methods. We conducted a systemic search on PubMed, Embase, Cochrane Library, Wanfang, and CNKI and selected randomized controlled trials (RCTs) to include. The efficacy of TRT on glycemia, insulin sensitivity, lipid profile, and body weight was meta-analyzed by Review Manager. Results. A total of 18 RCTs, containing 1415 patients (767 in TRT and 648 in control), were enrolled for the meta-analysis. The results showed that TRT could reduce HbA1c (MD = −0.67, 95% CI −1.35, −0.19, and P = 0.006 ) and improve HOMA-IR (homeostatic model assessment of insulin resistance) (SMD = −1.94, 95% CI −2.65, −1.23, and P < 0.0001 ). TRT could also decrease low-density lipoprotein (SMD = −0.50, 95% CI −0.82, −0.90, and P = 0.002 ) and triglycerides (MD = −0.64, 95% CI −0.91, −0.36, and P < 0.0001 ). In addition, TRT could reduce body weight by 3.91 kg (MD = −3.91, 95% CI −4.14, −3.69, and P < 0.00001 ) and waist circumference by 2.8 cm (MD −2.80, 95% CI −4.38, −1.21 and P = 0.0005 ). Erectile dysfunction (measured by IIEF-5) did not improve, while aging-related symptoms (measured by AMS scores) significantly improved. Conclusions. TRT improves glycemic control, insulin sensitivity, and lipid parameters in hypogonadism patients with T2DM and MetS, partially through reducing central obesity.

74 RISK OF TYPE 2 DIABETES AND METABOLIC SYNDROME AMONG LATINO CHILDREN AND ADOLESCENTS PRESENTING TO A WEIGHT LOSS PROGRAM

2005 ◽  
Vol 53 (2) ◽  
pp. S399.5-S399
Author(s):  
N. M. Mirza ◽  
L. Rhee ◽  
Porto F. Carreiro ◽  
M. Palmer ◽  
D. Davis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Children And Adolescents ◽  
Weight Loss Program ◽  
Latino Children

Prevalence of type 2 diabetes mellitus, metabolic syndrome, and related morbidities in overweight and obese children

2022 ◽  
Vol 0 (0) ◽  
Author(s):  
İsmail Dündar ◽  
Ayşehan Akıncı
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Type 2 Diabetes Mellitus ◽  
Glucose Tolerance ◽  
Children And Adolescents ◽  
Overweight Children ◽  
Obese Children

Abstract Objectives The aim of the study was to determine the prevalence of metabolic syndrome (MetS), type 2 diabetes mellitus (T2DM), and other comorbidities in overweight and obese children in Malatya, Turkey. Methods Retrospective cross-sectional study. We studied 860 obese and overweight children and adolescents (obese children Body mass index (BMI) >95th percentile, overweight children BMI >85th percentile) aged between 6 and 18 years. The diagnosis of MetS, impaired glucose tolerance (IGT), impaired fasting glucose (IFG), and T2DM were defined according to modified the World Health Organization criteria adapted for children. Other comorbidities were studied. Results Subjects (n=860) consisted of 113 overweight and 747 obese children of whom 434 (50.5%) were girls. MetS was significantly more prevalent in obese than overweight children (43.8 vs. 2.7%, p<0.001), and in pubertal than prepubertal children (41.1 vs. 31.7%, p<0.001). Mean homeostasis model assessment for insulin ratio (HOMA-IR) was 3.6 ± 2.0 in the prepubertal and 4.9 ± 2.4 in pubertal children (p<0.001). All cases underwent oral glucose tolerance test and IGT, IFG, and T2DM were diagnosed in 124 (14.4%), 19 (2.2%), and 32 (3.7%) cases, respectively. Insulin resistance (IR) was present in 606 cases (70.5%). Conclusions Puberty and obesity are important risk factors for MetS, T2DM, and IR. The prevalence of MetS, T2DM, and other morbidities was high in the study cohort. Obese children and adolescents should be carefully screened for T2DM, insulin resistance, hyperinsulinism, dyslipidemia, hypertension, IGT, and IFG. The prevention, early recognition, and treatment of obesity are essential to avoid associated morbidities.

scholarly journals Ultraviolet radiation, vitamin D and the development of obesity, metabolic syndrome and type-2 diabetes

2017 ◽  
Vol 16 (3) ◽  
pp. 362-373 ◽  
Author(s):  
Shelley Gorman ◽  
Robyn M. Lucas ◽  
Aidan Allen-Hall ◽  
Naomi Fleury ◽  
Martin Feelisch
Keyword(s):  
Nitric Oxide ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Vitamin D ◽  
Ultraviolet Radiation ◽  
Sun Exposure ◽  
Metabolic Dysfunction ◽  
Obesity Prevalence ◽  
The World

Obesity prevalence is increasing around the world; however, the causes are not known. Here, we discuss moderate sun exposure as a potential modifier of obesity and metabolic dysfunction, with a focus on sun-induced mediators such as vitamin D and nitric oxide.

scholarly journals Association between Irisin, hs-CRP, and Metabolic Status in Children and Adolescents with Type 2 Diabetes Mellitus

2019 ◽  
Vol 2019 ◽  
pp. 1-13 ◽  
Author(s):  
Leticia Elizondo-Montemayor ◽  
Adrian M. Gonzalez-Gil ◽  
Oscar Tamez-Rivera ◽  
Carla Toledo-Salinas ◽  
Mariana Peschard-Franco ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Children And Adolescents ◽  
Pediatric Population ◽  
Surrogate Marker ◽  
Metabolic Effects ◽  
Mexican Children ◽  
Hs Crp

Proinflammatory cytokines and the novel myokine irisin, a cleavage product of FNDC5, have been found to play a role in obesity and type 2 diabetes mellitus (T2DM). Irisin has been shown to increase browning of adipose tissue, thermogenesis, energy expenditure, and insulin sensitivity, yet its association with inflammatory markers is still limited. Circulating irisin has been found to be increased in obesity, while in adult subjects with T2DM decreased levels have been found. However, data establishing the association of circulating irisin in children and adolescents with T2DM has not been described in the literature. The objective of this study was to determine irisin plasma concentration and its association with metabolic and adiposity markers and with hs-CRP, a surrogate marker of inflammation used in clinical practice, in a pediatric population with T2DM. A cross-sample of 40 Mexican children and adolescents aged 7-17 were recruited, 20 diagnosed with T2DM and 20 healthy controls. Plasma irisin levels were found to be lower in the T2DM group compared with controls, which could be attributed to a reduced PGC-1α activity in muscle tissue with a consequent decrease in FNDC5 and irisin expression. Irisin concentration was found to be positively correlated with HDL-c, LDL-c, and total cholesterol, while negatively correlated with BMI, waist circumference, and triglycerides. However, after multiple regression analysis, only HDL-c correlation remained significant. hs-CRP was higher in the T2DM group and positively associated with adiposity markers, unfavorable lipid profile, insulin levels, and HOMA-IR, but no association with irisin was found. Given the favorable metabolic effects attributed to irisin, the low plasma levels found in children and adolescents with T2DM could exacerbate the inflammatory and metabolic imbalances and the intrinsic cardiovascular risk of this disease. We propose an “irisin-proinflammatory/anti-inflammatory axis” to explain the role of irisin as a metabolic regulator in obesity and T2DM.

Sign in / Sign up

Export Citation Format

Share Document