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Here, we describe seven cases of new-onset diabetes mellitus (DM) that developed soon after initiation of olanzapine treatment. Two of these cases presented with diabetic ketoacidosis (DKA). Although recent case reports have documented an association between chronic treatment with clozapine and hyperglycemia, 2–7 this report is the first to describe the development of new-onset DM with DKA during treatment with olanzapine. It expands upon a recent report8 of two cases of olanzapine-associated, new-onset DM. Possible mechanisms for the development of DM and DKA are discussed. The present case series includes five cases previously presented in abstract form. 9