Olanzapine-induced diabetic ketoacidosis in a Saudi female

ABSTRACT

A twenty-seven-year-old Saudi woman with a 10-year history of bipolar affective disorder required numerous hospitalizations. On her last admission, Olanzapine [15 mg q.i.d.] and Clonazepam [2 mg bid] were initiated. Before treatment with Olanzapine, she had normal random serum glucose levels. Her body weight was 75 kg, and her body mass index [BMI] was 33.3 kg/m[2]. On discharge, controlled-release sodium valproate [750 mg bid] was added to her regimen and Olanzapine dose was decreased to 10 mg/day. After few months, she developed progressive somnolence, polyuria, and polydipsia. Serum glucose was 800 mg/dl, and urine was positive [+3] for ketones. She was diagnosed as diabetic ketoacidosis [DKA]. Her weight had increased 9 kg. The patient was treated with intravenous fluids and insulin. She was placed on a sliding scale insulin regimen besides Metformin. Olanzapine was discontinued and replaced with Haloperidol