Valproate is associated with the highest risk of developing type 2 diabetes compared with other anticonvulsant mood stabilisers, according to a US cohort study.

In contrast, initiation of lamotrigine conferred the lowest risk of diabetes in children and adults with epilepsy and bipolar disorder, say researchers from Harvard Medical School in Boston.

“Metabolic risk is often a less known risk factor of treatment, but its potential effects can have a long-lasting impact on patients,” said study first author Dr Jenny Sun (PhD).

Writing in JAMA Network Open, Dr Sun and colleagues analysed medical record data from 274,000 adults and 74,000 children to determine the comparative safety of anticonvulsant mood stabilisers on the risk of type 2 diabetes mellitus (T2DM).