Drug induced Diabetes

Drug induced Diabetes

Drug induced diabetes, when use of specific medications create bad side effect on person and development of diabetes, that is Drug induced Diabetes. The usage some drugs for the long time or improper may developed many kinds of side effects and develop diseases like diabetes.

Diabetes is a silent killer disease. Diabetic person must control his sugar level in the body, after diagnosis the diabetes and must start treatment as well under the advises of physician and principals of medical science and must not ignore, otherwise it is very harmful for human body and life as well.

Drug-induced Diabetes 

Physicians prescribe many medicines for treatment like antibiotics, beta-blockers and steroids to get cure from diseases. The use of these drugs for the long time or improper may develop many kinds of side effects.

A number of medicines have side effects which include the raising of blood glucose levels.

A person suffers from Drug induced diabetes, when he take any specific medication, who Which becomes the cause of diabetes,s development.

Drug that Induced Diabetes

List of medicines who develop diabetes, due to insulin-production and secretion interfering:-

  • Didansoine
  • Pyriminil (Vacor)
  • Diphenylhydantoin
  • L-asparaginase Pentamidine
  • b-receptor antagonists
  • Didansoine
  • Tacrolimus
  • L-asparaginase Pentamidine
  • Opiates 
  • Didansoine

List of medicines who are cause of diabetes, due to a reduction of insulin effectiveness:-

  • Magisterial acetate
  • antagonists
  • Glucocorticoids
  • B-receptor
  • Protease inhibitors
  • Oral contraceptives
  • Growth hormone
List of drugs who develop effects on insulin sensitivity and secretion:-
  • Cyclosporine
  • Atypical antipsychotic
  • Thiazide diuretics
  • Diazoxide

Medication that may increase risk for Hypoglycemia

Medications you take on different health conditions may affect your body’s ability to manage insulin or blood sugar. When a person takes above medicine for treatment of any serious health problems, these medicines aggravate diabetes. Please consult the doctor before use of these medicines, he will suggest for you better option.

Steroids

Steroids can cause Drug induced Diabetes

Steroids can cause Drug induced Diabetes

Some groups of Steroids are under :-

Glucocorticoids

Glucocorticoids such as hydrocortisone, dexamethasone, prednisone, and methylprednisolone may induce diabetes. Because, physicians suggest these drugs in different types of disorder and also patients use it large doses.

The actual incidence of diabetes induced by these agents is unknown because of these variations and because the most powerful influences on the risk of steroid-induced diabetes is likely to be the underlying metabolic and non-metabolic disorders of the patient.

Thus, the presence of an asymptomatic underlying genetic risk or metabolic disorder (i.e., glucose intolerance) increase the risk for acute steroid induced diabetes.

When the corticosteroids used as replacement therapy, in the result, no changes reported that these medicines have reduced the risk of the development of diabetes.

An observation noted that 30 mg/day of hydrocortisone given to a patient with hypopituitarism, as replacement corticosteroids, in reaction, no glucose level increased. In one report, diabetes resolved when magistra was discontinued, but recurred upon re challenge.

Prednisone

This type of steroids, prednisone has relationship with diabetes developing. It happens when this steroid used for long time. In case of, anybody have to use this steroid for inflammation treatment purpose, first, must consult the doctor to get advice, about this medicine use.

Thiazides

Thiazide diuretics revolutionized is prescribed for the treatment of high blood pressure, but it discovered that Thiazide increase the risk of diabetes. It discovered after Subsequent experience that if the dose of this medicine reduced, then the risk of diabetes reduced mostly. This antibiotic has a weak inhibitory effect upon release of insulin from the beta cell. This effect is so marked in one member of the family, diazoxide, that this is used to control excessive insulin secretion by unresectable insulin.

The medicine Thiazides diuretics or “water pills” are used to treat high blood pressure (or hypertension). Through many Studies, it is discovered that thiazides can increase the risk of diabetes development. However, this medicine is helpful in heart diseases. Risk of diabetes becomes low, in case of, when this drug used in low doses.

Beta-blockers

It is observed that the medical specialists suggest Beta-blockers to treat high blood pressure and heart problems. The study shows that usage of beta-blockers in hypertension and for other heart diseases is linked to risk of diabetes.

A medicine named “nonselective”beta-blockers certainly may reduce this risk of diabetes.

These types of drugs effects and impaired insulin release, especially agents that are not selected for the ß1-receptor sub-type.

Several studies have linked chronic use of ß-blockers with an increased risk for the development of diabetes.

A latest research by the Atherosclerosis Risk in Communities discovered that the risk of diabetes was increased in the persons who are taking a beta-blocker for hypertension for many years duration as as compared with other medications.

The risk conferred by non-selective beta blockers may be enhanced if these are combined with a thiamine diuretic.

Antibiotics

Antibiotics can cause Drug induced Diabetes

Different form of Antibiotics


Fluoroquinolones are a group of some antibiotic agents.

This group includes the following agents:-

  • Ciprofloxacin
  • Gatifloxacin
  • Levofloxacin
  • Moxifloxacin
  • Norfloxacin
  • Ofloxacin
  • Rofloxacin

These agents exhibit their antimicrobial activity through inhibition of DNA gyrase and topoisomerase IV, enzymes involved in bacterial cell division. The study shows us that there are many evidences telling that the agents of this antibiotic group can induced hypoglycemia with gatifloxacin.

How the Fluoroquinolones increase blood sugar level ?

The medical scientists proposed that the fluoroquinolones may be a cause of insulin secretion from the pancreas and may have a pharmacokinetic or pharmacodynamics interaction with various antidiabetic agents, including sulfonylureas.

In a hospital, the dose of fluoroquinolones has given by oral and intravenous to the indoor and outdoor patients in result the Hypoglycemia has been reported and when the medication discontinued, the symptoms of Hypoglycemia gone away.

Indomethacin

Indomethacin is another antibiotic that can increase blood sugar level in any individual. Indomethacin is a non-steroid, antibiotic, who is given as an anti-inflammatory and osteoarthritis, but when this agent given to the individuals it reported the hypoglycemia in individuals. So it proposed that indomethacin having the greatest evidence of hypoglycemia likely due to the population being treated.

Effects of Indomethacin

Indomethacin develop many effects, some of them are under :-

  • Indomethacin Increases in pancreatic insulin secretion
  • Increases in glucose utilization in the periphery
  • Decreases in gluconeogenesis
    Decreases in insulin clearance

all symptoms indicate to hypoglycemic effects of these drugs.

Quinine

Quinine is an anti-malarial agent used acutely for systemic and cerebral disease, but in a survey of 30 hospitals, hundreds of cases of hypoglycemia have been reported with quinine therapy.

It is fact that quinine put effects on insulin and increase the insulin secretion from the beta cells and become a cause of diabetes. Though this medicine is given malaria infected persons, but reported of quinine-induced hypoglycemia.

The high or higher doses of quinine and repeated in less than an hour, are greater risk of hypoglycemia. The manufacturing authorities advise not to repeat this medicine before 4 hours to avoid the risk of hypoglycemia.

Pentamidine

Pentamidine is a drug that used as anti-fungal medicine who reveals its effects through a resistance of microbial nuclear metabolism. Pentamidine effects on beta cells of the pancreas, in virtue of this effects secretion of insulin increases. Due to the early release of insulin, effects develop in the pancreas cells, pancreas calls go to the death in virtue of early release of insulin

In case of Pentamidine given to the patient, intravenous or intramuscular, 6 to 40% risk of high blood sugar may increase.

Hypoglycemia is most commonly seen in patients with acquired immune deficiency syndrome treated for Pneumocystis carinii.

Pentamidine is associated with resultant pancreatic damage and risk of hypoglycemia. Although this association is linked with higher doses, higher cumulative doses, and prolonged use. Pentamidine is associated with resultant pancreatic damage and risk of hypoglycemia. Although this association is linked with higher doses, higher cumulative doses, and prolonged use.

List of these drugs is under:-

  • Clozapine
  • Olanzapine,
  • Risperidone.

The person who is taking these drugs should be carefully monitored. people who are on pre-diabetes before taking these drugs should consult their doctor about alternative options.

Protease inhibitors

Protease inhibitors like ritonavir is prescribed for the treatment of HIV as antiretroviral therapy, but it discovered that the usage of Protease inhibitors is some risk of diabetes and can develop diabetes by insulin resistance and affecting other cells in the body. In case of the doctor prescribe you the Protease Inhibitors Talk to your doctor about how to limit your diabetes risk while taking antiretroviral therapy for HIV.

Pentamidine

Pentamidine a drug gived to the pneumonia patient. This medicine given by injection can lead to problems with blood sugar, leading to the need for insulin treatment.

SYMPTOMS OF DRUG-INDUCED DIABETES

Neurogenic Symptoms of Hypoglycemia

Anxiety/arousal

HungerShaky/trembling

Parenthesis

Sweating

Neuroglycopenic Symptoms of Hypoglycemia

Blurry vision

Changes in behavior– irritability is often noted Pallor

Confusion/difficulty thinking

Difficulty speaking

Dizziness

Loss of consciousness

Seizures

Warmth

Fatigue

Weakness

Emotional lability

Physical Signs of Hypoglycemia

Increased systolic blood pressure

Sweating

Tachycardia

Common symptoms of hypoglycemia

Table 2 Physiological Response Based on Blood Glucose Level
Blood glucose levelClassificationPhysiological response
70 mg/dl(3.9mmol/1)HypoglycemiaGlucagon release
Epinephrine release
Growth hormone release
Cartisol release
54mg/dl(mmol/1)Symptomatic HypoglycemiaAutomonic Symptoms
36mg/dl(immol/1)Hypoglycemia affecting brain funtion (neuroglucopenia)Cognitive decline
18mg/dl(immol/1severe neuroglucopeniaComa
Seizures

Physical Morbidity of Hypoglycemia Physical symptoms

  • Anxiety,
  • Hunger,
  • Palpitations
  • Hungers
  • Weating
  • Neurologic impairment
  • Decline in cognitive
  • Function
  • Changes in behavior
  • Coma
  • Seizures

Psychological Morbidity of Hypoglycemia

  • Anxiety
  • Guilt related to being fearful of experiencing hypoglycemia
  • Fear of experiencing
  • Hypoglycemia
  • Overall happiness

Prevention Drug induced diabetes

Is the Drug-induced diabetes preventable?

Answer is possible but very difficult to take steps.

Drug that may able to pose the drug-induced diabetes must be avoided it if possible, this is a best and easy option to avoid drug-induced diabetes. The people who are on the risk for diabetes, they should discuss their doctor to their pre-diabetes condition, the doctor will subscribe the alternative drug according the patient condition. Although it is very difficult practiced to avoid the specific medication that subscribed for a disease to change that drug, but we can adopt the other media of treatment. We can adopt the herbal drug instead of generic drugs.

If avoiding is not possible, we should take steps to minimize the side effects of drugs and risk of drug-induced diabetes.

To avoid the risk of drug-induced we must follow these points:

  • Use extended-release/sustained-released products if that is Only option and there is no alternative drug instead of that drug.
  • Screen the patient’s medication profile for drug interactions – pharmacokinetics and Pharmacodynamics.
  • With continuing specific drug that is risky for drug-induced diabetes the doctor has to advice the patient to avoid the alcohol intake.
  • Physical activates are very essential to avoid the risk of diabetes.
  • Keep the diet plan healthy rich in fiber and less carb and starch

Learn more about the different types of diabetes:

Diabetes Types
Type 2 diabetesType 1 diabetesGestational diabetes
Diabetes TypesDrug-induced DiabetesDouble diabetes
Juvenile DiabetesBrittle DiabetesSecondary Diabetes
Diabetes InsipidusDiabetes MODYDiabetes LADA
Steroid-induced Diabetes

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