Olanzapine and the Spectrum of Drug-induced Diabetes: Unveiling Dual Risk Factors for Type 2 Diabetes and Acute-onset Ketoacidosis
Abstract
Olanzapine, a widely prescribed atypical antipsychotic, is associated with significant metabolic side effects including hyperglycemia and new-onset diabetes mellitus. While it often contributes to or mimic conventional type 2 diabetes through weight gain and insulin resistance, olanzapine can also induce a distinct, acute, ketosis-prone form of diabetes characterized by acute, severe hyperglycemia, and a high risk of diabetic ketoacidosis (DKA). This review summarizes the current understanding of olanzapine's multifaceted diabetogenic mechanisms, distinguishing its contributions to both type 2 diabetes and this severe drug-induced presentation, and emphasizes the critical implications for patient management, particularly concerning the acute manifestations of DKA. We also discuss its unique position within the broader classification of other types of diabetes and drug-induced etiologies.
Related
- Immune Checkpoint Inhibitor‐Induced Diabetic Ketoacidosis in a Patient With Pre‐Existing Type 2 Diabetes: A Case Report
- When diabetic ketoacidosis becomes a neurological emergency: cerebral edema in a child with new-onset type 1 diabetes mellitus - a case report and narrative review
- Comment on Lan et al. Reducing Diabetic Ketoacidosis in Pediatric Type 1 Diabetes: The Impact of Screening Programs and Early Disease-Modifying Treatment. J. Clin. Med. 2026, 15, 5865
- Sodium-glucose cotransporter-2 inhibitor-associated euglycemic diabetic ketoacidosis in an adolescent with type 2 diabetes.
- Aneurysmal Subarachnoid Hemorrhage Associated with Diabetic Ketoacidosis in a Patient with Insulin-Dependent Diabetes: An Autopsy Case Report
BibTeX
@article{nagamine2026olanzapine,
title = {{Olanzapine and the Spectrum of Drug-induced Diabetes: Unveiling Dual Risk Factors for Type 2 Diabetes and Acute-onset Ketoacidosis}},
author = {Takahiko Nagamine},
journal = {Internal Medicine},
year = {2026},
month = aug,
doi = {10.2169/internalmedicine.6312-25},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6312-25/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Olanzapine and the Spectrum of Drug-induced Diabetes: Unveiling Dual Risk Factors for Type 2 Diabetes and Acute-onset Ketoacidosis
AU - Takahiko Nagamine
PY - 2026
DA - 2026/08/01
JO - Internal Medicine
DO - 10.2169/internalmedicine.6312-25
UR - https://www.jstage.jst.go.jp/article/internalmedicine/65/15/65_6312-25/_article
AB - Olanzapine, a widely prescribed atypical antipsychotic, is associated with significant metabolic side effects including hyperglycemia and new-onset diabetes mellitus. While it often contributes to or mimic conventional type 2 diabetes through weight gain and insulin resistance, olanzapine can also induce a distinct, acute, ketosis-prone form of diabetes characterized by acute, severe hyperglycemia, and a high risk of diabetic ketoacidosis (DKA). This review summarizes the current understanding of olanzapine's multifaceted diabetogenic mechanisms, distinguishing its contributions to both type 2 diabetes and this severe drug-induced presentation, and emphasizes the critical implications for patient management, particularly concerning the acute manifestations of DKA. We also discuss its unique position within the broader classification of other types of diabetes and drug-induced etiologies.
SN - 1349-7235
SN - 0918-2918
ER -