Blood-sugar checks on antipsychotics
If you take an antipsychotic, your blood sugar (an HbA1c test) should be checked before you start and at least once a year.
The silent should: If you take an antipsychotic, your blood sugar (an HbA1c test) should be checked before you start and at least once a year.
In our analysis of de-identified U.S. psychiatric records, this step was missing 69% of the time it should have happened.
It is fixable: the best-performing clinics miss it only 11% of the time — a 58-point gap that is about the system, not the patient.
Why it matters: Incident T2DM in forward 12mo: 5.06x (95% CI 4.74-5.40) for A1c>=6.5 without metformin vs A1c<5.7 among monitored AP users.
Not everyone is missed equally: For Native American patients this step is missed 84% of the time, versus 46% for White patients.
This page is information to help you ask questions — it is not medical advice, and you should never start, stop, or change a medication on your own. Bring these questions to your clinician.
Questions for your doctor the next time you see them
Copy a line and ask it — these are questions, never instructions to change treatment.
- I take an antipsychotic - when was my last blood-sugar (HbA1c) test?
- Can we check my blood sugar and keep an eye on it over time?
The evidence
New type 2 diabetes in the following 12 months: 5.06x (95% confidence interval 4.74-5.40) for A1c>=6.5 without metformin vs A1c<5.7 among monitored antipsychotic users.
This page is informational and not medical advice. It describes care patterns across a population, not your situation. Bring these questions to a clinician who knows you.
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