PPI and glycaemic control
Last edited 07/2021 and last reviewed 08/2021
Use of PPIs leads to reductions in HbA1c
Type 2 DM (T2DM) is caused by peripheral insulin resistance and is usually characterized by beta-cell hyperplasia and hyperinsulinemia.
Proton pump inhibitors (PPIs) are widely used for the treatment of gastric acid-related diseases such as peptic ulcer disease and gastroesophageal reflux disease
- PPIs block the last enzyme in the gastric acid secretion system and, consequently, decrease gastric acid secretion and increase the blood concentration of the hormone gastrin
- some in vitro studies have demonstrated that gastrin induces be-cell neogenesis from pancreatic exocrine duct cells and increases beta-cell mass
- studies have shown that treatment with gastrin can induce the formation of new beta-cells under various conditions in animal models
- a retrospective cohort study with a follow-up period of 5 years involving 388,098 patients demonstrated a decreased risk of DM in upper gastrointestinal disease patients who used PPIs (1)
A systematic review has been undertaken (2):
- review of 7 studies (n=342) for glycaemic control and 5 studies (n=244,439) for risk of incident diabetes found add on PPI was associated with a significant decrease in HbA1c (-0.36 %; 95%CI, -0.68 to -0.05), but did not reduce the risk of incident diabetes.
Reference:
- in HC, Hsiao YT, Lin HL, Uang YS, Cheng HW, Wang Y, Wang LH. The use of proton pump inhibitors decreases the risk of diabetes mellitus in patients with upper gastrointestinal disease: A population-based retrospective cohort study. Medicine (Baltimore). 2016 Jul;95(28):e4195.
- Chiung-Hui Peng C et al. Effects of Proton Pump Inhibitors on Glycemic Control and Incident Diabetes: A Systematic Review and Meta-Analysis, The Journal of Clinical Endocrinology & Metabolism, 2021; dgab353, https://doi.org/10.1210/clinem/dgab353