Despite clear guidelines, clinicians rarely monitor glucose or lipids in patients receiving second-generation antipsychotics.

Guidelines for patients receiving second-generation antipsychotics on glucose or lipids testing before treatment initiation and during treatment are given based on a consensus reached by American Diabetes Association collaborated with associations of psychiatrists, endocrinologists, and obesity researchers.

The 5787 pre-guideline and 17,832 post-guideline subjects were prescribed aripiprazole, olanzapine, quetiapine, risperidone, or ziprasidone; were younger than 65; had not taken atypicals for 6 months previously; and continued their atypicals for 4 months after the study began. Testing rates were low overall, but significantly lower pre-guideline than post-guideline (baseline glucose testing: 17.3% of patients vs. 21.8%; 12-week glucose testing: 14.1% vs. 17.9%; baseline lipid testing: 8.4% vs. 10.5%; 12-week lipid testing: 6.8% vs. 9.0%).