Risperidone-associated transient diabetic ketoacidosis and diabetes mellitus type 1 in a patient treated with valproate and lithium - A case report

A 37-year-old man treated with valproate and lithium for bipolar affective disorder since 1999 and with risperidone since March 2003 was admitted to our clinic due to metabolic acidosis. Serum glucose was 647 mg/dL and urine ketones were positive. The patient was accepted as diabetic ketoacidosis (DKA). Risperidone, valproate, and lithium were immediately stopped, and the patient was treated with insulin and IV fluid replacement. Serum insulin and C-peptide levels were too low, and islet cell antibody and anti-GAD antibody were positive. We accepted him as type 1 diabetes mellitus (DM type 1). After the intensive treatment of diabetes, insulin requirements decreased gradually and diabetes mellitus disappeared completely within three months. Conclusion: Risperidone may lead to transient DM type 1 and DKA.