{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:09:00Z","timestamp":1786975740693,"version":"build-2736575974"},"reference-count":32,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Antipsychotic medications are widely prescribed to children and adolescents worldwide, raising concerns about treatment-emergent type 2 diabetes (T2D). Previous studies have reported elevated T2D risks but have relied on between-person comparisons susceptible to unmeasured confounding and have not characterized risk trajectories around treatment initiation.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine the annual prevalence of pharmacologically treated T2D before and after antipsychotic initiation in Dutch youths.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study used data from Dutch population-based registers to track yearly pharmacologically treated T2D prevalence up to 5 years before and after antipsychotic initiation among youths aged 0 to 19 years initiating such medication. Using fixed-effects models, the event study design controlled for all stable, person-specific confounders that limit standard between-person comparisons. Data were collected from January 1, 2006, to December 31, 2022, and analyzed beginning in February 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Antipsychotic initiation (first recorded dispensation).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n The primary outcome was annual prevalence of pharmacologically treated T2D, defined as at least 1 dispensation of a noninsulin glucose-lowering medication within a given year. Annual risk differences (RDs) and relative risk changes were estimated using the year preceding antipsychotic initiation as the reference.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 89\u202f991 youths who were dispensed at least 1 antipsychotic prescription between 2006 and 2022 (median [IQR] age at antipsychotic initiation, 13.6 [9.8-16.7] years; 55\u202f794 [62.0%] males) were included in the sample. In this cohort, pharmacologically treated T2D prevalence was stable before treatment and increased significantly after antipsychotic initiation. The RD increased from 2.47 (95% CI, 1.09-3.86) per 10\u202f000 antipsychotic users in the initiation year to 9.02 (95% CI, 5.99-12.06) per 10\u202f000 users by year 5. Females had greater absolute excess risk of T2D than males by year 5 (RD, 16.48 [95% CI, 8.95-24.00] per 10\u202f000 users vs 5.50 [95% CI, 2.57-8.43] per 10\u202f000 antipsychotic users). Adolescents aged 13 to 19 years had a larger long-term increase in risk than children aged 7 to 12 years (year-5 RD, 14.09 [95% CI, 8.19-19.98] per 10\u202f000 users vs 5.47 [95% CI, 2.76-8.18] per 10\u202f000 users). While recurrent users experienced greater, progressively increasing risk (RD, 10.17 [95% CI, 6.47-13.87] per 10\u202f000 antipsychotic users by year 5), elevated risk of pharmacologically treated T2D persisted among youths using antipsychotics in the initiation year only.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this within-individual cohort study, antipsychotic initiation in youths was associated with a rapid, sustained increase in treated T2D risk independent of underlying time-invariant factors. These findings indicate that even brief antipsychotic exposure is associated with a sustained metabolic vulnerability, underscoring the need for routine metabolic monitoring and preventive strategies from antipsychotic treatment initiation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.25377","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:30:33Z","timestamp":1785166233000},"page":"e2625377","source":"Crossref","is-referenced-by-count":1,"title":["Antipsychotic Exposure and Pharmacologically Treated Type 2 Diabetes in Dutch Youths"],"prefix":"10.1001","volume":"9","author":[{"given":"Ravish Nilish","family":"Gangapersad","sequence":"first","affiliation":[{"name":"Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands"},{"name":"Department of Applied Economics, Erasmus School of Economics, Erasmus University, Rotterdam, the Netherlands"},{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus Medical Center, Rotterdam, the Netherlands"},{"name":"Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Garc\u00eda-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Applied Economics, Erasmus School of Economics, Erasmus University, Rotterdam, the Netherlands"},{"name":"Tinbergen Institute, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit C. P.","family":"Koch","sequence":"additional","affiliation":[{"name":"Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, the Netherlands"},{"name":"Rotterdam Clinical Pharmacometrics Group, Erasmus University Medical Center, Rotterdam, the Netherlands"},{"name":"Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vahid","family":"Moghani","sequence":"additional","affiliation":[{"name":"Department of Applied Economics, Erasmus School of Economics, Erasmus University, Rotterdam, the Netherlands"},{"name":"Tinbergen Institute, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bram","family":"Dierckx","sequence":"additional","affiliation":[{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus Medical Center, Rotterdam, the 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M, Van Diest? B, Zantinge? E. Overgewicht Jongeren Volksgezondheid En Zorg. August 21, 2025. Accessed October 22, 2025. https:\/\/www.vzinfo.nl\/overgewicht\/jongeren"},{"key":"zoi260706r24","unstructured":"Biemond? KMC, Breur? JMPJ, Kloosterboer? SM. Antipsychotica: monitoring van bijwerkingen bij kinderen en adolescenten. Psyfar. Published online June 1, 2024. Accessed October 22, 2025. https:\/\/www.psyfar.nl\/tijdschrift\/editie\/artikel\/t\/antipsychotica-monitoring-van-bijwerkingen-bij-kinderen-en-adolescenten"},{"key":"zoi260706r31","unstructured":"Vermeulen? W, Pomp? M, ter Weel? B, William? L, Andras? H. Diabetes en werk. 2025. 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