What is the impact of antipsychotics on glucose metabolism and how should risk be monitored?

• A. Antipsychotics cure diabetes
• B. Some antipsychotics can cause weight gain and insulin resistance; monitor fasting glucose or HbA1c, weight, and counsel on diet and exercise
• C. There is no effect on glucose
• D. Only monitor liver enzymes

Answer: (B)

Antipsychotics can affect glucose metabolism, especially some atypical agents, by promoting weight gain and insulin resistance. This combination increases the risk of developing impaired glucose regulation or type 2 diabetes, so proactive monitoring is essential. Start with baseline metabolic screening and then track changes over time: regularly measure fasting glucose or HbA1c to gauge glycemic status, monitor weight or BMI to catch weight gain early, and provide counseling on diet and exercise to mitigate risk. Some guidelines also recommend checking lipids and blood pressure to assess metabolic syndrome risk, and if problems arise, consider treatment adjustments or additional lifestyle or medical interventions. The key point is recognizing that glucose metabolism can be affected and taking ongoing, proactive steps to monitor and manage that risk.