Drug-Induced Diabetes
Medicines have for many years, saved lives and improved our state of wellbeing in this generation. Without them, many of us would not be able to lead productive lives. However, some medicines have been discovered to induce diabetes in people previously undiagnosed which calls for sheer caution while handling them.
The extent of glucose intolerance in patients with secondary diabetes such as that which is drug induced can vary widely. Studies however have shown that drug induced diabetes prevalence accounts for an estimate of 1 to 3 percent of all diabetes cases.
In other words, a patient could be taking medication with the aim of treating an underlying ailment but in the process develops diabetes. As you read further, we discuss a few drugs discovered to raise a patient’s blood sugar leading to the development of diabetes.
What is drug induced diabetes?
First of all, drug induced diabetes is a form of secondary diabetes which develops in association with ailments or other factors other than those of gestational, type 1 or type 2 diabetes. It can develop from another health condition or pre-existing disease as well as medications administered to patients.
In some cases, the development of drug induced diabetes may be reversed if the use of the medication is discontinued. However, in other cases it may not be reversible.
Secondly, symptoms of drug induced diabetes can be subtle in early stages. But as time goes by, some people taking medications such as steroids may notice the following symptoms:
- Dry mouth.
- Weight gain and obesity
- Blurred vision.
- Increased thirst.
- Increased urge to urinate.
- Frequent exhaustion and lethargy.
Causes: Which drugs can make you diabetic?
General risk factors of diabetes include weight gain and obesity, polycystic ovarian syndrome and high cholesterol, heart disease, hormonal imbalances, infectious diseases to mention a few. This would indirectly lead to drug induced diabetes because, patients with such conditions are treated with medications that can induce diabetes such as statin drugs.
More factors are based on medications administered to patients not necessarily suffering from those conditions. Both licit and illicit drugs can lead to diabetes. People who abuse drugs are at a risk of developing metabolic syndrome and drug-induced diabetes. This is due to increased cell damage. Opioids can have a negative effect on glucose metabolism and poor diet choices.
This can be a challenge because, patients with chronic diseases may find it difficult to completely stop using the drugs that might push them to yet another lifestyle disease.
Some of these drugs are readily available in the market. Corticosteroids, a drug that is given to patients to help lower inflammation in the body are among those that can potentially bring diabetes to patients. The drug is used to treat arthritis, asthma, and allergies.
Other drugs are Thiazide diuretics that are used to treat high blood pressure, Beta-blockers, used to manage abnormal heart rhythms and to protect the heart from a second heart attack after a first heart attack.
Antipsychotics that are used for the treatment of bipolar disorder and statins which are the most common cholesterol-lowering drugs can also lead to diabetes in some patients. However, continuing with these drugs means that you risk getting diabetes topped with equally depressing health conditions.
How can we manage drug-induced diabetes?
Discontinuing the medication may reverse diabetes. However, there are instances when drug-induced diabetes becomes permanent. But there is light in the end of the tunnel. The doctor may prescribe small doses of the drugs or reduce the period of taking the drugs to reduce adverse side effects including those that might increase the level of blood sugar.
These smaller doses may enable patients to sail through treatment and successfully be able to stop the course of medication and manage the potential risk of complications.
At Afyacode doctors recommend patients to consider taking healthy meals and engage in physical exercises to help manage blood sugar levels. This ensures that risks of acquiring more complications such as drug induced diabetes while under medication are avoided.
Nonetheless, if you have already been diagnosed with drug induced diabetes, you may need to schedule for annual screenings for proper monitoring and treatment. Treatments vary based on the extent of insulin resistance and blood glucose levels. You and your doctor may opt to treat the condition with anti-diabetic medication or insulin among other medications that don’t induce diabetes.
In all, if in doubt about the medications you are taking for other ailments, talk to your doctor or pharmacist in your next appointments concerning these drugs that may induce diabetes. These drugs were identified by UpToDate (Source), a clinical decision support resource organisation:
Classification of drugs that may lead to drug induced diabetes:
| Drug group | Active ingredients (agents) | How can they trigger diabetes? |
| Anti-infective drugs | ||
| Fluoroquinolonones | Gatifloxacin, moxifloxacin | Altered insulin secretion. |
| HIV antivirals | Protease inhibitors, Nucleoside reverse transcriptase inhibitors (NRTIs) | Increased insulin resistance, which is part of antiretroviral-associated metabolic syndrome. |
| Other anti-infectives | Pentamidine | Altered pancreatic beta cell function and destruction following initial hypoglycemic effects |
| Cardiovascular drugs | ||
| Beta blockers | Atenenolol, metoprolol, propranolol | Moderate decreased insulin sensitivity. |
| Hypolipodemic | Niacin (nicotinic acid), statins | Statins lead to Glucose intolerance |
| Thiazide diuretics | Hydrochlorothiazide, chlorothalidone, chlorothiazide, indapamide | Decreased insulin secretion and resistance. |
| Vasodilators | Diazoxide | Reduced insulin secretion and sensitivity, increased hepatic glucose production |
| Vasopressors | Norepinephrine, epinephrine | Inhibition of insulin secretion, activation of gluconeogenesis, increased gluconeogenesis, simulation of glucagon and cortison. |
| Hormonal drugs | ||
| Sex hormones drugs eg Oral contraceptivesProgestin | Estrogen-progestin oral contraceptives, progestin-only contraceptives. Megestrol acetate | Altered hepatic glucose metabolism, increased insulin resistance. Low doses have little effect on carbohydrate metabolism in females. |
| Antipsychotic drugs | ||
| First-generation | Perphenazine, chlopromazine, phenothiazine agents | Mechanisms are not established. However, they are linked to increased insulin resistance and lower insulin secretion. |
| Second-generation | Clozapine, iloperidone, risperidone, olanzapine, paliperidone, quetiapine | |
| Immunosuppressant drugs | Sirolimus, Cyclosporine (cyclosporine), tacrolimus | Decreased insulin synthesis and release. |
| Glucocorticoids, systemic drugs | Glucocorticoids in general | Common cause of clinical drug induced hyperglycemia. Can cause increased hepatic glucose production, insulin resistance |