Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes

• Published in: Journal of the American Board of Family Medicine Vol. 25; no. 1; pp. 50 - 54
• Main Authors: Crouch, Michael A, Mefford, Ivan N, Wade, Ekpedeme U
• Format: Journal Article
• Language: English
• Published: United States 01-01-2012
• Subjects: Adult; Aged; Aged, 80 and over; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - physiopathology; Drug Therapy, Combination; Electronic Health Records; Female; Glycated Hemoglobin A - analysis; Glycated Hemoglobin A - drug effects; Hospitals, Community; Humans; Hypoglycemic Agents - therapeutic use; Male; Medical Audit; Metformin - therapeutic use; Middle Aged; Proton Pump Inhibitors - pharmacology; Proton Pump Inhibitors - therapeutic use; Retrospective Studies
• ISSN: 1557-2625; 1558-7118
• DOI: 10.3122/jabfm.2012.01.100161

Oral hypoglycemic medications sometimes do not control type 2 diabetes well. Proton pump inhibitors (PPIs) as adjunctive therapy might improve diabetes control through increasing serum gastrin and fasting insulin levels.
Electronic medical records in a family medicine residency program office practice were reviewed for 73 individuals with type 2 diabetes (not taking insulin), for whom PPIs were prescribed. Values for glycosylated hemoglobin (HbA1c) for periods of time when a PPI had been prescribed were compared with HbA1c levels for periods of time with no record of PPI prescribing or over-the-counter PPI use.
The mean HbA1c for patients not taking insulin was 7.11 during periods with recorded prescribing or over-the-counter use of PPIs, compared with 7.70 during periods without recorded PPI therapy (P = .001). Mean HbA1c for metformin monotherapy was not significantly different (6.81 with PPI vs. 7.10 without PPI; n = 16; P = .25). Mean HbA1c was significantly different for combination therapy that included metformin and/or sulfonylurea and/or giltazone (7.26 vs. 7.80; n = 27; P = .002).
The observed association between PPI therapy and lower HbA1c levels suggests that PPIs may be useful as adjunctive therapy for type 2 diabetes.