To the Editor.—
We read with interest the letter by Mukherjee et al1 in which an increased incidence of a high fasting blood sugar (FBS) level was found among subjects with tardive dyskinesia (TD). We would like to add that an impaired FBS level has been observed in other exprapyramidal disorders in which dopamine has been shown to play a pathogenetic role, namely, chorea2 and Parkinson's disease.3As early as 1960, Gates and Hyman4 reported on the efficacy of oral tolbutamide in diabetic subjects with PD, and in 1961 Barbeau5 found decreased glucose tolerance in 50% of subjects with PD. Van Woert and Mueller6 found increased FBS and decreased plasma insulin levels in 24 subjects with PD. These findings were attributed to a decreased release of pancreatic insulin in PD. Indeed, dopamine has been shown to stimulate insulin secretion (a βadrenergic—mediated mechanism)7 and
Gillman MA, Sandyk R. Tardive Dyskinesia and Glucose Metabolism. Arch Gen Psychiatry. 1986;43(2):192–193. doi:10.1001/archpsyc.1986.01800020102022
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