Diabetic ketoacidosis among patients receiving clozapine: a case series and review of socio-demographic risk factors.

Background. Diabetic ketoacidosis (DKA) has been associated with clozapine. The purpose of this study is to examine the clinical-demographic correlates of DKA among outpatients receiving clozapine.Methods. A literature search was conducted from 1966 to present using Medline to identify 23 case reports of clozapine-associated DKA. In addition, a cohort of twenty-six patients with clozapine-associated diabetes at the University of Rochester Medical Center Department of Psychiatry were examined for histories of DKA through review of medical records. Based on a total sample of 26 case reports including three unpublished cases at University of Rochester, associations between clinical and demographic variables and DKA were examined.Results. African American patients were significantly more likely than other patients to have DKA (p < 0.0001). Clozapine treatment duration was significantly shorter among patients with DKA than those without DKA (p < 0.0001), with 61.5% of patients developing DKA within three month...