Which Drugs Increase Diabetes Risk?

Steroids (Corticosteroids)

Steroid drugs can induce a form of iatrogenic Cushing’s syndrome, and are probably the most widely used drugs which confer a high risk of diabetes.

Corticosteroids mimic the action of cortisol, so are responsible for bringing on our body’s classic stress response of higher blood pressure and increased blood glucose levels. Corticosteroids blunt the action of insulin and promote hepatic gluconeogenesis, possibly by activation of liver x receptor-β involving phosphoenolpyruvate carbosykinase gene transcription.

Glucocorticoids also block the entry of glucose into the muscles and fat tissue by preventing glucose-transport proteins in the cells of those tissues from reaching the cell membrane, where they normally serve to remove glucose from the blood. These drugs have many other serious side effects, including osteoporosis, suppression of the adrenal glands, and cataracts.

The mechanism responsible for glucose intolerance after corticosteroids administration is similar to that of type 2 Diabetes since steroids increase insulin resistance, which can be up to 60%-80% depending on the dose and type used. So, Steroids are the main cause of drug-induced hyperglycemia. They not only exacerbate hyperglycemia in patients with known diabetes mellitus (DM), but also cause DM in patients without documented hyperglycemia before the initiation of glucocorticoids (GC) therapy, with an incidence that can reach up to 46% of patients, and increases in glucose levels up to 68% compared to baseline.

Hyperglycemia occurs in a majority of hospitalized patients receiving high doses of corticosteroids. Furthermore, in some populations they can precipitate acute complications such as nonketotic hyperosmolar state, and diabetic ketoacidosis and in a few instances death, especially in patients with pre-existing DM.

So, the risk of ketoacidosis as well as hyperglycemia should be considered in the course of glucocorticoid therapy.

Observational studies suggest that systemic absorption of topical steroids could be diabetogenic.

Birth control pills

Use of oral contraceptives containing estrogen is significantly associated with higher fasting insulin and insulin resistance. Past use of oral contraceptives increases the prevalence of insulin resistance and diabetes among postmenopausal women. Diabetes Risk Almost 35% Higher if Pill Used for >6 Months.

So, when it comes to oral contraception for diabetic women, experts most frequently recommend combination birth control pills that contain lowest dose of estrogen possible and norgestimate.

Thiazide diuretics

The exact mechanism of how thiazide diuretics (Hydrochlorothiazide and chlorthalidone) cause the development of hyperglycemia is unknown. However, it is postulated to involve worsening of insulin resistance, inhibition of glucose uptake, and decreased insulin release, among other pathways. In addition, thiazide diuretics are postulated to down-regulate peroxisome proliferator-activated receptor gamma, thereby decreasing insulin release in addition to activating the reninangiotensin-aldosterone system, thus resulting in elevated levels of aldosterone and resulting hyperglycemia.

Another proposed mechanism of thiazide-induced hyperglycemia involves thiazide-induced hypokalemia possibly through impairment of potassium-dependent insulin release in response to glucose load. However, hypokalemia is an inconsistent finding in people who develop hyperglycemia or diabetes when taking a thiazide diuretic.

In studies, those taking HCTZ had fasting blood sugar levels that were 2-3 mg/dl higher than those not taking the drug, and as a result, also had a 12% to 18% higher risk for diabetes. Hydrochlorothiazide has been implicated in contributing to new-onset diabetes in as few as 9–18 weeks of therapy initiation.

Beta Blockers

Beta-blockers work by blocking the release of adrenaline and noradrenaline which helps to reduce blood pressure and reduce heart rate. Diabetes-unfriendly beta-blockers (Atenolol, Bisoprolol and Metoprolol) effectively treat high blood pressure but may raise blood sugars as well. β-blockers are thought to contribute to the development of hyperglycemia by impairing the release of insulin from the pancreatic β-cell.

The several large studies that have looked at the risk of diabetes associated with beta-blockers include the Nurses Health Studies I and II and the ongoing ARIC (Atherosclerosis Risk in Communities) study. In these two studies, the risk of developing diabetes in people originally without it who took beta-blockers was approximately 20% to 28% greater than in those who did not take beta-blockers.

This may seem counterintuitive since people with diabetes are often warned that beta-blockers can cause problems with low blood glucose, not high blood glucose. Beta-blockers cause these two problems in distinct ways. First, they may harm a person’s ability to recognize and respond to low blood glucose, mainly by keeping the heart rate slow, which can dampen symptoms of hypoglycemia. They may also inhibit the release of glucose from the liver. But beta-blockers also block the release of insulin by interacting with nerve signals to the pancreas and can thus lower insulin levels even when blood glucose is high.

There is some evidence that not all beta-blockers affect insulin secretion. Interestingly, carvedilol and nebivolol are not associated with the development of hyperglycemia or new-onset diabetes.

Diabetes-friendly beta-blockers like carvedilol, nebivolol, and labetalol are associated with fewer hospitalizations for hyperglycemia but increased all-cause rehospitalizations among nursing home residents with diabetes and recent acute myocardial infarction, according to research published in Diabetes, Obesity & Metabolism.

Several studies have shown that a combination of beta-blockers and thiazide diuretics, as expected, also produces an increase in the risk of developing diabetes, by approximately 20%. Development of adverse metabolic effect, including new-onset diabetes mellitus associated with short-term exposure to hydrochlorothiazide and atenolol was more common in those with abdominal obesity.

ACE inhibitors and calcium channel blockers have not been strongly linked to diabetes. ACE inhibitors and calcium channel blockers have not been strongly linked to diabetes.

Drugs that treat anxiety, ADHD, depression, and other mental health problems.

Atypical antipsychotics (aripiprazole, risperidone, olanzapine, quetiapine, ziprasidone, clozapine, lanzapine/fluoxetine) are associated with hyperglycemia and an increased risk of new-onset diabetes.

The schizophrenia and depression medications, clozapine, olanzapine and quetiapine have been linked to a three-fold increase in diabetes risk. CLozapine and olanzapine, can cause much worse metabolic side-effects including body weight gain, obesity, hyperlipidaemia, insulin resistance, hyperglycaemia and diabetes (Foley and Morley, 2011; De Hert et al., 2012; Deng, 2013; Lipscombe et al., 2014; Stubbs et al., 2015). 

The development of diabetes and resultant hyperglycemia, however, is likely a complex interplay of the atypical antipsychotic’s likelihood of promoting weight gain (e.g., olanzapine and clozapine) through the involvement of multiple mechanisms. These mechanisms involve, but are not limited to, antagonism at 5-HT receptors (serotonin receptors) mainly involving 5-HT2C, which is involved in regulation of food intake; antagonism at central histamine H1 receptors; development of insulin resistance through effects on cellular glucose transporters; compromised insulin secretion; and alterations in leptin levels.

Although weight gain occurs with conventional antipsychotic agents such as haloperidol, greater weight gain definitely occurs with chlorpromazine, olanzapine, and clozapine and may occur with risperidone and quetiapine.  A consensus statement from the American Diabetes Association and the American Psychiatric Association recognizes that antipsychotic drugs, and in particular olanzapine and clozapine, can elevate blood glucose, cause weight gain, and increase blood lipids. These drugs also raise the risk for diabetic ketoacidosis.

Phenytoin (Dilantin) and valproic acid (Depakene) are seizure medications that may block the pancreas from releasing insulin and cause blood sugar levels to rise. In a study of patients with epilepsy, almost half of the patients treated with valproic acid were found to have high blood sugar levels.

Long-term use of the following antidepressant medications is associated with an increased risk for diabetes: fluvoxamine (Luvox), mirtazapine (Remeron), paroxetine (Paxil) and sertraline (Zoloft). More specifically, an increased risk for high blood sugar is seen with high or moderately high daily doses of these drugs (not low daily doses).

Antibiotics (Fluoroquinolones)

Fluoroquinolones (Gatifloxacin, levofloxacin and ciprofloxacin) are the only class of antibiotics that can elevate blood sugar, especially in older adults or folks who are already diabetic. The risk for high blood sugar with these medications is relatively low. However, gatifloxacin is more likely to cause high blood sugar than levofloxacin or ciprofloxacin. Interestingly, gatifloxacin is also associated with the development of hypoglycemia. The proposed hypoglycemic mechanism involves binding of the antibiotic to the pancreatic β-cell similar to the action of sulfonylureas.

Calcineurin Inhibitors (CNIs)

Calcineurin is a protein phosphatase that activates T cells of the immune system. The CNIs cyclosporine, sirolimus, and tarcrolimus are often used to avoid allograft rejection in transplantation therapy.

The postulated mechanism of hyperglycemia results from inhibition of pancreatic islet β-cell expansion promoted by calcineurin.

Prostate Drugs Increase Diabetes Risk

The risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5α-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Men being treated with dutasteride or finasteride for benign prostatic hyperplasia (BPH) have a roughly 30 per cent increased risk of developing diabetes.

Researchers have discovered a link between SGLT2 inhibitors and Fournier gangrene – an infection that affects the genitals.

Leuprolide and Goserelin are common medications used to treat prostate cancer. Using either of them can increase your risk for diabetes by almost 30%. How? Both drugs cause your body to be more resistant to the sugar-lowering effects of insulin.

Statins May Double the Risk of Type 2 Diabetes

The findings, which appear in the journal Diabetes Metabolism Research and Reviews, revealed that people who took statins were more than twice as likely to receive a diabetes diagnosis than those who did not take the medication. Additionally, people who took statins for longer than 2 years were more than three times as likely to develop diabetes.

Individuals who take cholesterol-lowering statins may be at higher risk for developing high blood sugar levels, insulin resistance, and eventually type 2 diabetes, according to an analysis published in the British Journal of Clinical Pharmacology. Compared with participants who never used statins, those who used statins tended to have higher concentrations of serum fasting insulin and insulin resistance. Participants who ever used statins had a 38 percent higher risk of developing type 2 diabetes during the study.

Regular use of statins, a group of drugs used to treat high cholesterol, can cause as much as a 12% increase in blood sugar levels. How? Insulin is the hormone that helps your cells take up glucose. Statin medications result in less insulin secretion and make your cells less sensitive to insulin. More potent statins like atorvastatin, rosuvastatin and simvastatin cause a larger increase in blood sugar than less potent statins like pravastatin.

Protease Inhibitors

Protease inhibitors are essential components of antiretroviral therapy for the treatment of people with HIV and AIDS. Protease inhibitor–associated hyperglycemia may occur in treated people with or without diabetes and occurs in 3–17% early in therapy or after extensive and prolonged use.

Hyperlipidemia and insulin resistance are induced by protease inhibitors independent of changes in body composition in patients with HIV infection. Ritonavir has been shown to directly inhibit glucose transporter type 4 activity in vivo, accounting for its ability to cause hyperglycemia.

OTC medicines that can raise your blood sugar include:

By | 2019-08-20T11:28:54+00:00 August 20th, 2019|Uncategorized|9 Comments

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  1. zen August 20, 2019 at 11:26

    What medication causes diabetes?

    Many therapeutic agents can predispose to or precipitate diabetes, especially when pre-existing risk factors are present, and these may cause glucose control to deteriorate if administered to those with existing diabetes. They may act by increasing insulin resistance, by affecting the secretion of insulin, or both. For convenience, these agents may be subdivided into widely used medications that are weakly diabetogenic, and drugs used for special indications that are more strongly diabetogenic. Examples of the former include antihypertensive agents and statins, and examples of the latter include steroids, antipsychotics and a range of immunosuppressive agents. There are also a number of known beta cell poisons including the insecticide Vacor, alloxan and streptozotocin.

  2. zen August 20, 2019 at 11:57

    Which drugs can cause hyperglycemia?

    Some common medications that can increase glucose levels:
    Valium and Ativan (benzodiazepines)
    Thiazide diuretics, which are taken as blood pressure medicine.
    The steroids cortisone, prednisone, and hydrocortisone.
    Birth control pills.
    Progesterone.
    Catecholamines, which include the EpiPen and asthma inhalers.

  3. zen August 20, 2019 at 11:59

    Non-Diabetes Drugs and Supplements That Affect Glucose Levels

    Some common medications that can increase glucose levels:

    Valium and Ativan (benzodiazepines)
    Thiazide diuretics, which are taken as blood pressure medicine
    The steroids cortisone, prednisone, and hydrocortisone
    Birth control pills
    Progesterone
    Catecholamines, which include the EpiPen and asthma inhalers
    Decongestants that contain pseudoephedrine
    Niacin
    Zyprexa and many other antipsychotic medications
    Some common medications or supplements that can cause low glucose levels:

    Aspirin
    Asian ginseng
    Aloe
    Magnesium salicylate
    Quinine

    Each time you get a prescription for a new medication, try to read the info that comes with the medication or ask the pharmacist if they know about any effects the medicine might have on blood sugar levels. If you start to take any vitamins or herbal supplements, you should also mention these to your doctor so they can check if there are interactions.

    If you’ll be using a medicine long-term, talk to your doctor about its effect on glucose levels and if there is an alternative that could be taken that has no effect. If not, work on a plan with your diabetes care team to evaluate the effect and, if necessary, come up with a way to counter it.

    If a medication you need appears on this list or the Diabetes in Control list, it doesn’t mean you can’t use it. There just may need to be adjustments made to other diabetes medications to offset any effects.

  4. zen August 20, 2019 at 14:47

    Drugs That Can Raise Blood Glucose

    Certain Antibiotics
    Of all the different antibiotics, the ones known as quinolones are the only ones that may affect blood glucose. They are prescribed for certain types of infection.

    Levofloxacin (Levaquin)
    Ofloxacin (Floxin)
    Moxifloxacin (Avelox)
    Ciprofloxacin (Cipro, Cipro XR, Proquin XR)
    Gemifloxacin (Factive)
    Second Generation Antipsychotics
    These medicines are used for a variety of mental health conditions. There is a strong association between these medicines and elevated blood sugar, and frequent monitoring is recommended.

    Clozapine (Clozaril)
    Olanzapine (Zyprexa)
    Paliperidone (Invega)
    Quietiapine (Seroquel, Seroquel XR)
    Risperidone (Risperdal)
    Aripiprazole (Abilify)
    Ziprasidone (Geodon)
    Iloperidone (Fanapt)
    Lurasidone (Latuda)
    Pemavanserin (Nuplazid)
    Asenapine (Saphris)
    Beta Blockers
    Beta blockers are used to treat high blood pressure and certain heart conditions. Not all available beta blockers have been shown to cause high blood sugar.

    Atenolol
    Metoprolol
    Propranolol
    Corticosteroids
    Corticosteroids are used to treat conditions where there is inflammation, such as arthritis and bone and joint injuries. They are also used for asthma, severe allergy, COPD, and during cancer therapy. Corticosteroids, also known as steroids, are strongly associated with elevated blood sugar, and frequent monitoring is recommended. Inhaled steroids, and those applied to the skin, are not likely to affect blood sugar.

    Prednisone (Steripred)
    Prednisolone (Prelone and others)
    Methylprednisolone (Medrol, Depo-Medrol)
    Hydrocortisone (Cortef)
    Dexamethasone (Decadron)
    Fludrocortisone (Florinef)
    Betamethasone (Celestone)
    Diuretics
    Diuretics are used to reduce excess fluid in the body, and to treat high blood pressure. Many people with type 2 diabetes take one of these drugs. In lower doses, they are less likely to affect blood sugar.

    Chlorthalidone
    Hydrochlorothiazide
    Indapamide
    Metolazone
    Calcineurin Inhibitors (CNIs)
    These medicines are used in organ transplant patients to prevent rejection.

    Cyclosporine (Genfgraf, Neoral, Sandimmune)
    Tacrolimus (Astagraf XL, Invarsus XR, Prograf)
    Sirolimus (Rapamune)
    Protease Inhibitors
    These medicines are used to treat HIV and AIDS.

    Atazanavir (Reyataz)
    Darunavir (Prezista)
    Fosamprinavir (Lexiva)
    Indinavir (Crixivan)
    Nelfinavir Viracept)
    Ritonivir (Norvir)
    Saquinavir (Invirase)
    Tipranivir (Aptivus)
    Statins
    Statins lower cholesterol levels, and are recommended for most people with type 2 diabetes to reduce the risk of heart attack and stroke. The benefits of heart attack and stroke prevention far outweigh the risk of elevating blood sugar.

    Rosuvastatin (Crestor)
    Lovastatin (Mevacor)
    Simvastatin (Zocor)
    Atorvastatin (Lipitor)
    Pravastatin (Pravachol)
    Fluvastatin (Lescol)
    Pitavastatin (Livalo)
    Niacin (Nicotinic Acid)
    Niacin is used to lower triglycerides and cholesterol. In higher doses, it can raise blood sugar.

    Niacin (Niaspan, Niacor, Slo-Niacin and various non-prescription products)
    Over-The-Counter (Non-Prescription) Medicines That May Affect Blood Sugar
    The most common offenders are in the class of medicines known as decongestants. Decongestants don’t contain sugar, but cause the release of stored sugar into the bloodstream. They are used to reduce nasal congestion, often during cold season and allergy season. There are two decongestants available in the U.S. and one, pseudoephedrine, is usually kept behind the counter, to be sold only by a pharmacist. These decongestants are included in many multi-symptom products.

    Some examples:

    Nyquil Severe Cold and Flu liquid (phenylephrine)
    Tylenol Multi-Symptom Severe liquid (phenylephrine)
    Robitussin Severe Multi-Symptom liquid (phenylephrine)
    Alka-Seltzer Day/Night Multi-Symptom (phenylephrine)
    Advil Cold and Sinus tablets (pseudoephedrine)
    Mucinex D tablets (pseudoephedrine)
    Allegra D tablets (pseudoephedrine)
    The second category is products that actually contain sugar: most often cough syrups, cough drops, and lozenges. The extent of the effect on blood sugar relates to the amount taken per dose, and the number of doses taken daily. As an example, a non-sugar-free cough drop may contain 2 to 4 grams of sugar, and a typical non-sugar-free cough syrup may contain 3 to 5 grams of sugar per two teaspoons. Multi-symptom cough and cold syrups may contain sugar as well as a decongestant. These are almost always available in a sugar-free variety, but they may be more expensive and taste slightly different than those containing sugar.

    Some examples:

    Robitussin Cough Syrup
    Robitussin DM Cough Syrup
    Luden’s cough drops
    Hall’s cough drops
    One other medicine that can affect blood glucose is ephedrine. It’s an ingredient in the asthma medicines Primatene and Bronkaid. Ephedrine is known to cause elevated blood pressure, blood sugar, and heart rate, and is best avoided.

    Remember, too, herbal and other “natural” products may contain chemicals that can affect your diabetes, and you should always consult your healthcare provider before taking these products. Your pharmacist is also a great resource for information on the products they stock in the pharmacy, so do not hesitate to ask advice.

  5. zen August 20, 2019 at 15:18

    What Medicines Can Make Your Blood Sugar Spike?

    If you have diabetes or high blood sugar, you probably know some of the things that cause your glucose (another name for blood sugar) to go up. Like a meal with too many carbohydrates, or not enough exercise. But other medicines you might take to keep yourself healthy can cause a spike, too.

    Know Your Meds
    Medicines you get with a prescription and some that you buy over the counter (OTC) can be a problem for people who need to control their blood sugar.

    Prescription medicines that can raise your glucose include:

    Steroids (also called corticosteroids).
    They treat diseases caused by inflammation, like rheumatoid arthritis, lupus, and allergies. Common steroids include hydrocortisone and prednisone. But steroid creams (for a rash) or inhalers (for asthma) aren’t a problem.

    Drugs that treat anxiety, ADHD, depression, and other mental health problems.
    These can include clozapine, olanzapine, risperidone, and quetiapine.

    Birth control pills
    Drugs that treat high blood pressure, such as beta-blockers and thiazide diuretics
    Statins to lower cholesterol
    Adrenaline for severe allergic reactions

    High doses of asthma medicines, or drugs that you inject for asthma treatment
    Isotretinoin for acne

    Tacrolimus, which you get after an organ transplant
    Some medicines that treat HIV and hepatitis C
    OTC medicines that can raise your blood sugar include:

    Pseudoephedrine, a decongestant in some cold and flu medicines
    Cough syrup. Ask your doctor if you should take regular or sugar-free.
    Niacin, a B vitamin

    How Do You Decide What to Take?
    Even though these medicines can raise your blood sugar, it doesn’t mean that you shouldn’t take them if you need them. The most important thing is to work with your doctor on the right way to use them.

    If you have diabetes or you’re watching your blood sugar, ask your doctor before you take new medicines or change any medicines, even if it’s just something for a cough or cold. (Remember, just being sick can raise your blood sugar.)

    Make sure your doctor knows all the medicines you take — for diabetes or any other reason. If one of them may affect your blood sugar, she may prescribe a lower dose or tell you to take the medicine for a shorter time. You may need to check your blood sugar more often while you’re taking the medicine, too.

    Also, remember to do the things you know will help keep your levels under control. Exercise, eat right, and take any diabetes medicines that you need.

  6. zen August 20, 2019 at 18:50

    Antidepressant May Affect Glucose Metabolism

    Antidepressants can worsen glycemic control and/or induce hyperglycemia….

    The use of antidepressants has increased over recent years. There have been concerns about the use of antidepressants in patients with diabetes. Selective serotonin reuptake inhibitors (SSRIs) can worsen glycemic control in diabetics while tricyclic antidepressants can induce hyperglycemia in patients. Some studies adjusted for the change in body weight and still observed an increase risk of diabetes in patients using antidepressants. This may suggest other factors are contributing to diabetes. Other medications such as antipsychotics may alter insulin resistance or secretion.

    Crucitti et al’s study on the effects of duloxetine showed no significant change in fasting plasma glucose or HbA1c in short-term therapy. But in the long-term, the researchers saw a statistically significant increase in HbA1c in patients with chronic lower back pain.

    The authors concluded there might be a link between antidepressants and diabetes. But since the probability is low, the majority of patients who are receiving the medication will not develop diabetes. More studies should be conducted to see if the combination of antidepressants with diabetic patients has additive effects. As of now, there are many conflicting studies.

    Practice Pearls:
    Antidepressants may contribute to insulin resistance with weight gain.
    TCAs induce hyperglycemia.
    Antipsychotics may alter insulin resistance.
    American Diabetes Association October 2013

  7. zen August 20, 2019 at 19:14

    High Blood Sugar? It Could Be a Side Effect of These Medications

    Popular medications like statins and diuretics can come with the side effect of raising your blood sugar levels—and that can be a problem whether or not you have diabetes. Fortunately, if you discover that your medication is giving you high blood sugar, you can usually reverse the effect by switching to a different treatment. Keep your eyes out for these common culprits.

    Simvastatin, atorvastatin and rosuvastatin
    Regular use of statins, a group of drugs used to treat high cholesterol, can cause as much as a 12% increase in blood sugar levels. How? Insulin is the hormone that helps your cells take up glucose. Statin medications result in less insulin secretion and make your cells less sensitive to insulin. More potent statins like atorvastatin, rosuvastatin and simvastatin cause a larger increase in blood sugar than less potent statins like pravastatin.

    Hydrochlorothiazide and chlorthalidone
    Hydrochlorothiazide (HCTZ) and chlorthalidone are diuretics used to lower blood pressure but may increase your risk for high blood sugar and diabetes. In studies, those taking HCTZ had fasting blood sugar levels that were 2-3 mg/dl higher than those not taking the drug, and as a result, also had a 12% to 18% higher risk for diabetes.

    Atenolol and metoprolol
    Atenolol and metoprolol are beta-blockers which effectively treat high blood pressure but may raise blood sugars as well. It’s not all beta-blockers though. Carvedilol (Coreg), for example, does not affect blood sugar levels.

    Using a steroid like prednisone—which treats rheumatoid arthritis, asthma and COPD—can result in high blood sugar levels depending on the size of your dose and how long you use the medication. Steroids both block the pancreas from releasing insulin into the bloodstream and increase how much glucose (sugar) the liver makes.

    Leuprolide and goserelin
    Lupron (leuprolide) and Zoladex (goserelin) are common medications used to treat prostate cancer. Using either of them can increase your risk for diabetes by almost 30%. How? Both drugs cause your body to be more resistant to the sugar-lowering effects of insulin.

    Clozapine, olanzapine and quetiapine
    The schizophrenia and depression medications, clozapine, olanzapine (Zyprexa) and quetiapine (Seroquel), have been linked to a three-fold increase in diabetes risk. These drugs limit how much insulin is secreted by the pancreas in response to high blood sugar.

    HIV medications
    Antiretroviral therapy (ART) for HIV/AIDS has been linked to an increased risk of diabetes. There’s good news though: Newer treatments like Isentress (raltegravir), Tivicay (dolutegravir) and Selzentry don’t increase blood sugars.

    Phenytoin and valproic acid
    Phenytoin (Dilantin) and valproic acid (Depakene) are seizure medications that may block the pancreas from releasing insulin and cause blood sugar levels to rise. In a study of patients with epilepsy, almost half of the patients treated with valproic acid were found to have high blood sugar levels.

    Antidepressants
    Long-term use of the following antidepressant medications is associated with an increased risk for diabetes: fluvoxamine (Luvox), mirtazapine (Remeron), paroxetine (Paxil) and sertraline (Zoloft). More specifically, an increased risk for high blood sugar is seen with high or moderately high daily doses of these drugs (not low daily doses).

    Gatifloxacin, levofloxacin and ciprofloxacin
    Gatifloxacin, levofloxacin and ciprofloxacin are antibiotics that can elevate blood sugar, especially in older adults or folks who are already diabetic. The risk for high blood sugar with these medications is relatively low. However, gatifloxacin is more likely to cause high blood sugar than levofloxacin or ciprofloxacin.

  8. zen August 20, 2019 at 19:46

    Powerful new cancer drugs can trigger diabetes — and no one is certain why

    Immunotherapy, a powerful new form of cancer treatment that harnesses the body’s immune system to treat cancer, is leading to a troubling side effect.

    Roughly 1% of patients who receive the treatment develop type 1 diabetes, in which the body stops producing the glucose-regulating hormone insulin.

    Scientists are working to figure out why that’s happening, ideally to find ways to reverse the side effect.

  9. zen August 20, 2019 at 19:49

    5α-Reductase Inhibitors Might Increase Risk for Diabetes

    Diabetes risk was 30% higher among dutasteride and finasteride users than tamsulosin users.

    Previous studies have shown that dutasteride, a steroid 5α-reductase inhibitor used to treat patients with benign prostatic hyperplasia (BPH), induced insulin resistance and increased blood glucose and glycosylated hemoglobin levels. In this study, researchers sought to determine whether either of the 5α-reductase inhibitors (dutasteride or finasteride) confers excess risk for type 2 diabetes compared with tamsulosin (an α-blocker also used to manage BPH but not known to cause insulin resistance). Two population-based cohorts from the U.K. and Taiwan were evaluated.

    U.K. participants were 55,000 men (mean age, 70) who received ≥2 prescriptions for dutasteride, finasteride, or tamsulosin. After a mean 5.2-year follow-up, 2100 men had developed type 2 diabetes. Adjusted for multiple variables, risk for type 2 diabetes was 32% and 26% higher in the dutasteride and finasteride groups, respectively, than in the tamsulosin group. Similar results were obtained for the Taiwan cohort and in propensity score–matched analyses.

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