SUN-148 Are Glp Analogues Superior For Diabetes And Weight Control In Patients On Antidepressant Medications?

Abstract

Introduction: Obesity and diabetes are much more common in patients with mental illnesses compared to the general population; and both, antipsychotic as well as antidepressant medications have been associated with adverse metabolic outcomes. A retrospective data analysis of patients seen in our diabetes clinic revealed that patients on AntiPsychotic Medications (APM) particularly benefited from GLP (Glucagon-Like Peptide) analogues compared to alternative regimens. In addition to HbA1c reductions, patients on GLP analogues lost about 7 kg weight after one year; patients on alternative diabetes regimens gained 2 kg (1). Furthermore, HbA1c reductions were blunted in patients who were on APM andAntiDepressant Medications (ADM), but NOT if treated with GLP analogues. Patients on APM and ADM had significantly larger HbA1c reductions after therapy with a GLP analogue compared to alternative regimens (1). HYPOTHESIS: We hypothesized that patients on ADM ALONE might similarly benefit from GLP analogues, both in terms of weight as well as glycemic control. RESULTS: We conducted a retrospective chart review of patients on ADM seen in our diabetes clinic between 2016-2018. So far, 20 patients were included into this retrospective analysis. Ten were on GLP analogues (cases), ten were on alternative antidiabetic agents (controls). Cases and controls did not significantly differ in age, sex, height and weight at the time of referral. Within one year, a reduction in HbA1c (mean±SE) was noted in both groups (-1.19±0.86% for cases, -0.6±0.67% for controls) with a trend towards a larger HbA1 reduction in the cases, i.e. patients treated with a GLP analogue (p=0.1). In addition, patients on GLP analogues lost 2.87±3.15kg weight, control patients lost 0.71±0.95kg (p=0.5). CONCLUSIONS: In summary, GLP analogues promote both glycemic and weight control in diabetic patients on ADM; they may be superior to alternative antidiabetic regimens. Additional, prospective studies are needed to confirm and validate these promising trends. REFERENCES: Perlis L, Miedlich SU. GLP analogues are superior for diabetes and weight control in patients on antipsychotic plus/minus antidepressant medications. Diabetes 2018 Jul; 67 (Supplement 1): 2294-PUB.