Valproate has highest diabetes risk among anticonvulsant mood stabilizers: JAMA

USA: Valproate is linked to the highest risk of acquiring type 2 diabetes (T2D) in adults, according to recent cohort research published in the Journal of the American Medical Association.

Treatment with anticonvulsant mood stabilizers is linked to an increased risk of weight gain, but less is known regarding the risk of acquiring T2D. Jenny W. Sun and colleagues conducted this investigation to assess the comparative safety of anticonvulsant mood stabilizers on the risk of T2D in adults and children using an emulation of a target trial.

This observational cohort research employed IBM Market Scan data from 2010 to 2019, with a 5-year follow-up period. Children (aged 10-19 years) and adults (aged 20-65 years) were included in the countrywide sample of commercially insured patients who began anticonvulsant mood stabilizer therapy. The data was examined from August 2020 to May 2021. This research enrolled patients who had begun and continued to take carbamazepine, oxcarbazepine, lamotrigine, or valproate. The major consequence was the onset of T2D during the follow-up period. The researchers utilized weighted pooled logistic regression to determine the relationship between starting and continuing carbamazepine, oxcarbazepine, lamotrigine, or valproate with the likelihood of developing T2D. To account for confounding and loss to follow-up caused by observed baseline and time-varying factors, inverse probability weights were applied.