OBJECTIVES: Hyperglycemia and type 2 diabetes mellitus (T2DM) are common adverse drug events (ADEs) of second-generation antipsychotics (SGA) in both children and adults, yet a similar universal monitoring schedule is recommended for both age groups. Limited evidence exists on blood glucose monitoring and its positive rates (hyperglycemia, T2DM) in youth on SGA from childhood to young adulthood and its correlation with age. This study aimed to describe the age-related trends of monitoring and positive monitoring rates among SGA recipients aged 10 to 25.

METHODS: A trend analysis of the BG monitoring and monitoring positive rates by age was conducted using the 2009 to 2018 TriNetX Electronic Medical Record database. The temporal trends of the BG monitoring rate, positive BG monitoring rate, and T2DM diagnosis rate were examined using the Autoregressive Integrated Moving Average (ARIMA) model. The best-fitted model was selected using the white noise residual test and Schwarz information criterion test statistic.

RESULTS: Despite a threefold increase (5% to 15%) in BG monitoring rates among SGA recipients aged 10 to 25, the proportion of patients identified with hyperglycemia or diagnosed with T2DM remained relatively stable (1-2%) with increasing age. In addition, the ARIMA (1,1,0) model, identified as the best fit, revealed that a one-year older age is associated with a 0.60 (95%CI: 0.17 -1.04) increase in BG monitoring rates and hyperglycemia detection rates decreased (Slope = -0.50 [95%CI: -0.97 - -0.03]) while T2DM diagnosis rates increased (Slope = 0.02 [95%CI: -0.66 - 0.71]) from childhood to adulthood.

CONCLUSIONS: The BG monitoring rate among SGA recipients significantly increased from childhood to young adulthood, while the detection rate of hyperglycemia or T2DM in this group remained low despite aging. Findings suggest that monitoring high-risk youth may be a more efficient strategy than the universal monitoring practice recommended by the current guidelines.