Shows increasing metabolic medication use in youth treated with antipsychotics, suggesting a shift in diabetes management strategies.
Introduction and Objective: Youth treated with antipsychotic medications have a 2-3-fold higher risk of new-onset diabetes than youth who do not receive an antipsychotic. Metformin is the standard of care, but this may be replaced by newer FDA-approved treatments, such as glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose cotransporter-2 inhibitors (SGLT2i). We aimed to examine trends in metabolic medications - metformin, GLP-1RA, and SGLT2i - among US youth receiving antipsychotics. Methods: Using the IQVIA PharMetrics® Plus for Academics claims data 2016-2024, we examined annual cross-sectional trends in metformin, GLP-1RA, and SGLT2i in youth 5-17 years-old treated with an antipsychotic. We estimated the quarterly prevalence over the entire study period, overall and stratified by age (5-11, 12-17 years) and sex. Results: The 61,792 antipsychotic-treated youth were male (57%) and 5-11 years-old (69%). Metabolic medication use increased from 2.4% (2016) to 4.3% (2024). GLP-1RA use reached 0.8% in the most recent quarter. Less than 0.05% used SGLT-2i. Metformin is the most prevalent overall, and for females and 12-17-year-olds. Conclusion: Metabolic medication use in antipsychotic-treated youth remains low but trending upward with recent uptake of GLP-1RA among 12-17 year-old females. Disclosure O. Iyalomhe: None. A. Amill-Rosario: None. R. McCoy: None. S. dosReis: None.
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