The risk of developing type 2 diabetes has been linked to a number of different factors, including your family history, body weight, and physical activity level. It has also been known or suspected for years that certain drugs and chemicals can also increase the risk of developing type 2.
While any link between a medication and an increased diabetes risk should be cause for concern, a recent study shows an alarming connection between some of the most popular prescription and over-the-counter drugs for acid reflux (heartburn) and a significantly higher risk of developing type 2. These results suggest that new screening procedures for diabetes may be needed in people who regularly take these drugs.
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Longer use of drugs, higher diabetes risk
The study, published in the journal Gut, followed over 200,000 participants in a long-term health study called the Nurses’ Health Study. At the beginning of the study, none of these people had diabetes, but during a follow-up period that averaged about 10 years, over 10,000 participants developed diabetes — in the vast majority of cases, type 2.
As noted in a news release on the study from the BMJ journal group (which includes Gut), the researchers found that taking proton pump inhibitors (PPIs) was tied to an increased risk of developing type 2. PPIs are among the top 10 most commonly used drugs worldwide, and are used to treat acid reflux, indigestion and peptic ulcers. Common brand names include Aciphex (rabeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), and Protonix (pantoprazole).
Long-term use of these drugs has already been associated with a number of different health concerns, including a higher risk of bone fractures, chronic kidney disease, intestinal infections and stomach cancer.
After controlling for differences between participants who took PPIs and those who didn’t, the researchers found that participants who took these drugs were 24% more likely to develop type 2 diabetes overall. But this risk wasn’t even across the board among PPI users. Those who took a PPI for up to 2 years had a 5% higher risk of developing type 2, while those who took a PPI for over 2 years had a 26% higher diabetes risk.
The researchers found that the risk of diabetes among PPI users wasn’t affected by factors such as sex, age, family history of diabetes, smoking, alcohol intake, diet or physical activity. But among PPI users, not being overweight or having normal blood pressure actually increased the risk of developing type 2, compared with those who were overweight or had high blood pressure.
Once people stopped taking a PPI, the risk of developing type 2 fell over time.
Increased diabetes screening recommended
Since this study was observational — meaning that no one was assigned to take a drug or not take it as part of the study — it can’t establish cause and effect. But it’s not a stretch to suggest that PPIs could increase the risk of type 2 diabetes.
These drugs work by limiting stomach acid production, which can alter the makeup of gut bacteria over time. Other studies suggest that these changes may play a role in raising the risk of type 2 diabetes.
Since PPIs are such commonly used drugs, and since their long-term use appears to significantly raise the risk of type 2 diabetes, the researchers suggest than anyone taking a PPI for at least two years should regularly have their blood glucose checked for signs of diabetes.
What’s more, the researchers caution that doctors should carefully weight the potential risks and benefits of prescribing or recommending PPIs. In some cases, there may be alternative options available, including other antacids or dietary changes to avoid symptoms.
Want to learn more about Type 2 diabetes? Read “Tips to Prevent Type 2 Diabetes,” “Diabetes Testing: Type 2 Diabetes” and “Diabetes Awareness: Delay or Prevent Type 2 Diabetes.”