Second-generation
antipsychotics (SGAs) tend to induce
weight gain,
dyslipidemia and
diabetes mellitus. For those reasons, patients treated with SGAs should receive appropriate monitoring to avoid morbidity and mortality associated with
cardiovascular disease. We conducted a one-year follow-up study using Japanese
blood glucose monitoring guidance in
schizophrenia patients treated with SGAs to evaluate the detection capability of the guidance in real clinical settings and to assess the importance of longitudinal monitoring. This retrospective cohort study included
schizophrenia patients receiving at least one SGA, who were enrolled during June 2008-January 2009 at multiple sites and who had both baseline data and follow-up monitoring data at month 12. After one-year follow-up, the probable diabetes type (fasting
blood glucose is higher than 125 mg/dL, casual
blood glucose is higher than 179 mg/dL, or
glycosylated hemoglobin (
Hb(A1c)) is greater than 6.4%) was detected in 30 (8%) of the patients, and the pre-diabetes type (fasting
blood glucose is 110-125 mg/dL, or casual
blood glucose is 140-179 mg/dL, or
Hb(A1c) is 6.0-6.4%) in 65 (17.4%) out of the total of 374 patients. During the follow-up period, 1.5% of patients had advanced from the normal (fasting
blood glucose is less than 110 mg/dL, casual
blood glucose is less than 140 mg/dL, or
Hb(A1c) is less than 6.0%) to probable diabetes type and 42.4% had progressed from the pre-diabetes to probable diabetes type. Predictive factors for worsening of the diabetic state were a family history of diabetes, and high serum total-
cholesterol and
triglyceride levels at baseline. Not only cross-sectional baseline screening but also longitudinal follow-up screening is important to detect
glucose abnormalities in patients treated with SGAs.