Remission of Type 2 Diabetes in a Bipolar Patient on Atypical Antipsychotic Therapy-A Case Report

Background: To draw attention on the management of patients with type 2 diabetes treated with atypical neuroleptic drugs and to document that remission of the endocrinologic picture can take place even in patients under this treatment. To the best of our knowledge, this is the first report to show the remission of type 2 diabetes after starting therapy with atypical antipsychotic. Case presentation: We describe a patient who was diagnosed with type 2 diabetes in 2001 and was in treatment with insulin. He started in 2014 an atypical antipsychotic therapy for bipolar disorder at the Fondazione Policlinico Gemelli with a parallel change in life style (i.e., diet and multi-weekly physical activity). In 2019, after 4 years of integrated diabetic psychiatric therapy, the endocrinological picture of the patient entered into remission, the patient has been able to stop insulin therapy and is currently receiving only oral antidiabetic drug. Conclusion: Despite evidence supports association between antipsychotic drugs and type 2 diabetes in psychiatric patients, causality has not been established yet. As shown by this case report lifestyle could be at the basis of the high prevalence rates of type 2 diabetes in these patients and also linked to the possibility of its remission. It is necessary to carry out studies to better clarify the association between atypical neuroleptic drugs and type 2 diabetes onset considering the high morbidity and mortality of patients with type 2 diabetes, particularly during the current Sars- Cov-2 pandemic and the highest lethal rate of infection in these patients. Keywords Type 2 diabetes; Atypical antipsychotics; Bipolar disorder; Comorbidity; Lifestyle; Case report; Insulin; Oral antidiabetic drugs