According to the study – published in ‘Gut’, a journal specializing in the field of gastroenterology and hepatology – the regular use of drugs for acid reflux, known as ‘proton pump inhibitors’ (PPI), is associated with an increased risk of developing type 2 diabetes.
Medicines like omeprazole, pantoprazole, lansoprazole and the like are part of the group of PPI inhibitors.
The researchers note that this is an observational study and, as such, cannot establish a causal relationship, but it does involve many people whose health has been monitored for a relatively long period.
The longer these drugs are taken, the greater the risk appears to be, according to the research, which leads researchers to advise that people who take them for two or more years should have regular blood glucose check-ups to screen for blood sugar. diabetes.
Given the high risk of diabetes, doctors should carefully weigh the pros and cons of prescribing these drugs, they warn.
“For patients who need to receive long-term treatment, screening for abnormal blood glucose and type 2 diabetes is recommended,” suggest the study authors.
PPIs are used to treat acid reflux, peptic ulcers and indigestion and are among the 10 most used drugs worldwide.
In 2014, the overall prevalence of type 2 diabetes was 8.5%, and researchers wanted to find out whether the widespread use of proton pump inhibitors and the high prevalence of diabetes may be related.
The researchers relied on information provided by 204,689 participants (176,050 women and 28,639 men) aged 25 to 75 years collected since 1976.
At the time of registration and every two years, participants updated information on their health behaviors, medical history and newly diagnosed conditions.
From 2000 to 2004, participants were also asked whether they had used PPIs regularly in the previous two years: regular use was defined as two or more times a week.
During the average monitoring period of between nine and 12 years in all three groups, 10,105 participants were diagnosed with type 2 diabetes.
The absolute annual risk of a diagnosis among regular PPI users was 7.44 / 1000 compared to 4.32 / 1000 among those who did not take these drugs.
After taking into account the potentially influential factors, including high blood pressure, high cholesterol, physical inactivity and use of other medications, those who used PPI regularly were 24% more likely to develop type 2 diabetes than those who did not.
And the longer these drugs were taken, the greater the risk of developing diabetes: use for up to two years was associated with a 5% higher risk; use for more than two years was associated with an increased risk of 26%.
The risk decreased the more time that passed since it was stopped.
Further analysis showed that the risk of diabetes among PPI users was not affected by factors such as gender, age, family history of diabetes, smoking, alcohol intake, diet, physical activity, high cholesterol or regular use of anti-inflammatory drugs .
For comparison, the researchers also looked at the potential impact of H2 blockers, another type of substance used to contain excessive stomach acid production, and their regular use was associated with an increased risk of 14%.
Likewise, long-term use was associated with a higher risk, while the longest time since the interruption was associated with a lower risk.
The researchers also report that they have found evidence that changes in the type and quantity of bacteria normally present in the intestine (the microbiome) may help explain the associations found between the use of PPIs and an increased risk of developing diabetes.