From the Guidelines
Seroquel (quetiapine) can be used in patients with type 1 diabetes, but requires careful monitoring due to potential effects on blood glucose. Quetiapine, like other atypical antipsychotics, may cause hyperglycemia and in some cases worsen glycemic control in diabetic patients 1. If you have type 1 diabetes and are prescribed Seroquel, regular blood glucose monitoring is essential, particularly when starting the medication or adjusting the dose. You may need to adjust your insulin regimen in consultation with your healthcare provider, as intensive insulin therapy (≥3 injections of insulin per day) or continuous subcutaneous insulin infusion can improve glycemic control and reduce the risk of microvascular complications and cardiovascular disease 1. Watch for symptoms of hyperglycemia such as increased thirst, frequent urination, fatigue, or blurred vision. Weight gain is another common side effect of Seroquel that can indirectly affect diabetes management. The mechanism behind Seroquel's effect on blood glucose isn't fully understood but may involve changes in insulin sensitivity or secretion. Despite these concerns, many people with type 1 diabetes can safely take Seroquel when the benefits outweigh the risks and with appropriate monitoring in place, including education on matching prandial insulin doses to carbohydrate intake, preprandial blood glucose levels, and anticipated activity level 1. Always inform all your healthcare providers about your diabetes diagnosis and all medications you're taking. It is also important to note that patients with type 1 diabetes should use insulin analogues to reduce hypoglycemia risk 1, and continuous glucose monitoring systems can significantly reduce severe hypoglycemia risk in patients with type 1 diabetes 1.
From the FDA Drug Label
Quetiapine fumarate tablets can cause serious side effects, including: • high blood sugar (hyperglycemia). High blood sugar can happen if you have diabetes already or if you have never had diabetes High blood sugar could lead to: o build up of acid in your blood due to ketones (ketoacidosis) o coma o death Increases in blood sugar can happen in some people who take quetiapine fumarate tablets. Extremely high blood sugar can lead to coma or death If you have diabetes or risk factors for diabetes (such as being overweight or a family history of diabetes) your healthcare provider should check your blood sugar before you start quetiapine fumarate tablets and during therapy Call your healthcare provider if you have any of these symptoms of high blood sugar (hyperglycemia) while taking quetiapine fumarate tablets: o feel very thirsty o need to urinate more than usual o feel very hungry o feel weak or tired o feel sick to your stomach o feel confused, or your breath smells fruity
Type 1 Diabetes and Seroquel:
- Key Points:
- Quetiapine (Seroquel) can cause high blood sugar (hyperglycemia) in some patients.
- Patients with diabetes, including type 1 diabetes, should be monitored regularly for worsening of glucose control while taking quetiapine.
- Patients with risk factors for diabetes should undergo fasting blood glucose testing at the beginning of treatment and periodically during treatment.
- Recommendation: Patients with type 1 diabetes who are taking quetiapine should be closely monitored by their healthcare provider for signs of high blood sugar and should follow their recommended treatment plan to manage their diabetes. 2 2
From the Research
Type 1 Diabetes and Seroquel
- There is limited research directly linking type 1 diabetes and Seroquel (quetiapine) 3.
- However, one study found that low-dose quetiapine was not associated with an excess risk of type 2 diabetes compared to selective serotonin reuptake inhibitors (SSRIs) 3.
- The primary focus of research on type 1 diabetes has been on insulin therapy and management, with studies highlighting the importance of insulin regimens that yield physiologic results in patients with type 1 diabetes 4, 5.
- Other studies have explored alternative treatments for type 2 diabetes, including glucagon-like peptide-1 (GLP-1) receptor agonists, which may offer superior benefits to insulin in certain cases 6.
- Type 1 diabetes is a chronic disease caused by autoimmune destruction of pancreatic β cells, and individuals with the condition are reliant on insulin for survival 7.
Insulin Therapy in Type 1 Diabetes
- Insulin therapy is a crucial aspect of type 1 diabetes management, with various regimens and strategies available to achieve optimal glycemic control 4, 5.
- Rapid-acting insulin analogues and continuous subcutaneous insulin infusion have been shown to be effective in improving glycemic control and reducing hypoglycemia 4, 5.
- The choice of insulin regimen should be individualized based on patient needs and preferences, with consideration given to factors such as lifestyle, diet, and physical activity 5.
Seroquel and Diabetes
- While there is limited research on the specific link between Seroquel and type 1 diabetes, studies have investigated the association between quetiapine and type 2 diabetes 3.
- The available evidence suggests that low-dose quetiapine may not be associated with an increased risk of type 2 diabetes, but further research is needed to fully understand the relationship between quetiapine and diabetes 3.