Hyperglycemia
Physicians should consider the risks and benefits when prescribing olanzapine to patients with an established diagnosis of diabetes mellitus, or having borderline increased blood glucose level (fasting 100-126 mg/dL, non-fasting 140-200 mg/dL). Patients taking olanzapine should be monitored regularly for worsening of glucose control. Patients starting treatment with olanzapine should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment. Any patient treated with atypical antipsychotics should be monitored for symptoms of hyperglycemia including polydipsia, polyuria, polyphagia, and weakness. Patients who develop symptoms of hyperglycemia during treatment with atypical antipsychotics should undergo fasting blood glucose testing. In some cases, hyperglycemia has resolved when the atypical antipsychotic was discontinued; however, some patients required continuation of anti-diabetic treatment despite discontinuation of the suspect drug [see Patient Counseling Information (17.4)].
Hyperglycemia, in some cases extreme and associated with ketoacidosis or hyperosmolar coma or death, has been reported in patients treated with atypical antipsychotics including olanzapine. Assessment of the relationship between atypical antipsychotic use and glucose abnormalities is complicated by the possibility of an increased background risk of diabetes mellitus in patients with schizophrenia and the increasing incidence of diabetes mellitus in the general population. Epidemiological studies suggest an increased risk of treatment-emergent hyperglycemia-related adverse reactions in patients treated with the atypical antipsychotics. While relative risk estimates are inconsistent, the association between atypical antipsychotics and increases in glucose levels appears to fall on a continuum and olanzapine appears to have a greater association than some other atypical antipsychotics.
Mean increases in blood glucose have been observed in patients treated (median exposure of 9.2 months) with olanzapine in phase 1 of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE). The mean increase of serum glucose (fasting and nonfasting samples) from baseline to the average of the 2 highest serum concentrations was 15.0 mg/dL.
In a study of healthy volunteers, subjects who received olanzapine (N=22) for 3 weeks had a mean increase compared to baseline in fasting blood glucose of 2.3 mg/dL. Placebo-treated subjects (N=19) had a mean increase in fasting blood glucose compared to baseline of 0.34 mg/dL.
Olanzapine Monotherapy in Adults — In an analysis of 5 placebo-controlled adult olanzapine monotherapy studies with a median treatment duration of approximately 3 weeks, olanzapine was associated with a greater mean change in fasting glucose levels compared to placebo (2.76 mg/dL versus 0.17 mg/dL). The difference in mean changes between olanzapine and placebo was greater in patients with evidence of glucose dysregulation at baseline (patients diagnosed with diabetes mellitus or related adverse reactions, patients treated with anti-diabetic agents, patients with a baseline random glucose level ≥200 mg/dL, and/or a baseline fasting glucose level ≥126 mg/dL). Olanzapine-treated patients had a greater mean HbA1c increase from baseline of 0.04% (median exposure 21 days), compared to a mean HbA1c decrease of 0.06% in placebo-treated subjects (median exposure 17 days).
In an analysis of 8 placebo-controlled studies (median treatment exposure 4-5 weeks), 6.1% of olanzapine-treated subjects (N=855) had treatment-emergent glycosuria compared to 2.8% of placebo-treated subjects (N=599). Table 2 shows short-term and long-term changes in fasting glucose levels from adult olanzapine monotherapy studies.
Table 2: Changes in Fasting Glucose Levels from Adult Olanzapine Monotherapy Studies
a Not Applicable.
Up to 12 weeks exposure At least 48 weeks exposure
Laboratory Analyte Category Change (at least once)
from Baseline Treatment Arm N Patients N Patients
Fasting
Glucose Normal to High
(<100 mg/dL to ≥126 mg/dL) Olanzapine 543 2.2% 345 12.8%
Placebo 293 3.4% NAa NAa
Borderline to High
(≥100 mg/dL and <126 mg/dL to ≥126 mg/dL) Olanzapine 178 17.4% 127 26.0%
Placebo 96 11.5% NAa NAa
The mean change in fasting glucose for patients exposed at least 48 weeks was 4.2 mg/dL (N=487). In analyses of patients who completed 9-12 months of olanzapine therapy, mean change in fasting and nonfasting glucose levels continued to increase over time.
LaurieShay
I know that is alot of info, maybe more than what you wanted, but I thought best to include it all and let you decide what is useful. I think as long as the doctor monitors your glucose levels periodically, the benefits may outweigh the risks. If you have further concerns please google "zyprexa (olanzapine) and blood glucose levels" and there are several sites for you to read about this topic.
Hope I have helped some,
Laurie
LaurieShay gave you excellent info and I do not know the percentage myself but I do know it affected me. I took Zyprexa off and on for short intervals. While I was on the medication I had a terrible craving for sweets. That was one of the reasons I quite taking it. Years later I was diagnosed with diabetes but I dont see the connection due to the time frame and the periodic way I took it.
Drug companies started putting more emphasis on this side effet about the time I was diagnosed (I also have a family hx) They have to list side effects if even one person has it.
Talking to your doctor and having knowledge such as LauireShay gave you can help you know when you might be experiencing changes in your blood sugars and a regular monitor of your blood sugars by your doctor might help you feel more comfortable if you take or planning to take the medicine.
That is not exactly the answer to your ?, I just remember taking it, how I felt, what happened to me and the fact that I did not believe it caused my diabetes.
I wish you well~