Effect of Proton Pump Inhibitor Administration on Glycemic Parameters in Patients with Type 2 Diabetes Mellitus
Men's Health Journal,
Vol. 5 No. 1 (2021),
6 January 2021
,
Page e28
https://doi.org/10.22037/mhj.v5i1.35209
Abstract
Introduction: Proton pump inhibitors can influence glucose-insulin homeostasis by elevating plasma gastrin. Considering the few clinical trials and contradictory results of previous studies, we aimed to evaluate the effect of omeprazole, a proton pump inhibitor, on glucose-insulin homeostasis in patients with type 2 diabetes mellitus (T2DM). Materials and Methods: In this before-after clinical trial, 40 patients with T2DM received omeprazole treatment for 12 weeks. Patients were asked to continue their diet, lifestyle, and physical activity throughout the study period. Glycosylated hemoglobin (HbA1c), fasting plasma sugar (FBS), insulin level, C-peptide and 2 hours post prandial blood sugar (2hppBS) were measured at baseline and after 12 weeks. Homeostatic model assessment of Insulin resistance (HOMA-IR) and homeostatic model assessment of β-cell dysfunction (HOMA-B) indices were also calculated at baseline and after 12 weeks of omeprazole administration. Results: After 12 weeks of omeprazole administration, there was a clear decrease in the mean HbA1C before (8.11±0.96) and after (7.13±0.68) the treatment (P<0.001). Similarly, a decrease in mean FBS and 2HPPBS before and after treatment was observed, which was statistically significant for FBS (P=0.01) but not for 2HPPBS (P=0.1). There was a clear increase in the level of Insulin (P=0.001) and C-peptide (P=0.003). The mean activity index of HOMA-B before and after receiving omeprazole was 54.41 27.06 and 79.24 45.32, respectively (P=0.007). Also, HOMA-IR index was 5 before, and 6 after receiving omeprazole (P=0.001). Conclusion: Administration of omeprazole, increases insulin levels and decreases the levels of HbA1c, FBS, thus improving glycemic status and can be combined with other drugs used to manage DM, especially in patients with gastrointestinal problems; but more studies are needed.
- Diabetes mellitus
- Gastrin; HbA1c
- Proton pump inhibitors
- omeprazole
- glycemic control
How to Cite
References
Federation ID. IDF diabetes atlas ninth. Dunia: IDF. 2019.
DeFronzo RA. From the triumvirate to the „ominous octet”: a new paradigm for the treatment of type 2 diabetes mellitus. Clinical Diabetology. 2009;10(3):101-28.
Boj-Carceller D. Proton pump inhibitors: impact on glucose metabolism. Endocrine. 2013;43(1):22-32.
Menéndez Torre E, Lafita Tejedor F, Artola Menéndez S, Millán Núnez-Cortés J, Alonso Garcıa A, Puig Domingo M. Working Group for Consensus and Clinical Guidelines of the Spanish Diabetes Society. Recommendations for the pharmacological treatment of hyperglycemia in type 2 diabetes. Endocrinol Nutr. 2011;58:112-20.
Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J. Harrison's principles of internal medicine 19th Ed: McGraw-Hill Medical; 2014.
Endocrinologists AAoC. American College of Endocrinology consensus statement on guidelines for glycemic control. Endocr Pract. 2002;8(Suppl 1):5-11.
Control D, Group CTR. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England journal of medicine. 1993;329(14):977-86.
. 2011.
file://www.who.int/diabetes/publications/report-hba1c_2011.pdf (Accessed on June 07, 2011).
Kilpatrick ES. Glycated haemoglobin in the year 2000. Journal of clinical pathology. 2000;53(5):335-9.
Gerstein HC. Fasting versus postload glucose levels: why the controversy? : Am Diabetes Assoc; 2001.
Rohlfing CL, Wiedmeyer H-M, Little RR, England JD, Tennill A, Goldstein DE. Defining the relationship between plasma glucose and HbA1c: analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial. Diabetes care. 2002;25(2):275-8.
Cculloch D. Estimation of blood glucose control in diabetes mellitus. 2008. www uptodate com/online/content/diabetes HbA1C in type.2:455-9.
Dockray G, Dimaline R, Varro A. Gastrin: old hormone, new functions. Pflügers Archiv. 2005;449(4):344-55.
Schubert ML. Gastric secretion. Current opinion in gastroenterology. 2010;26(6):598-603.
Rooman I, Lardon J, Bouwens L. Gastrin stimulates β-cell neogenesis and increases islet mass from transdifferentiated but not from normal exocrine pancreas tissue. Diabetes. 2002;51(3):686-90.
Suarez-Pinzon WL, Yan Y, Power R, Brand SJ, Rabinovitch A. Combination therapy with epidermal growth factor and gastrin increases β-cell mass and reverses hyperglycemia in diabetic NOD mice. Diabetes. 2005;54(9):2596-601.
Suarez-Pinzon WL, Lakey JR, Brand SJ, Rabinovitch A. Combination therapy with epidermal growth factor and gastrin induces neogenesis of human islet β-cells from pancreatic duct cells and an increase in functional β-cell mass. The Journal of Clinical Endocrinology & Metabolism. 2005;90(6):3401-9.
Singh PK, Hota D, Dutta P, Sachdeva N, Chakrabarti A, Srinivasan A, et al. Pantoprazole improves glycemic control in type 2 diabetes: a randomized, double-blind, placebo-controlled trial. The Journal of Clinical Endocrinology & Metabolism. 2012;97(11):E2105-E8.
Bödvarsdóttir T, Hove K, Gotfredsen C, Pridal L, Vaag A, Karlsen A, et al. Treatment with a proton pump inhibitor improves glycaemic control in Psammomys obesus, a model of type 2 diabetes. Diabetologia. 2010;53(10):2220-3.
McDonagh MS, Carson S, Thakurta S. Drug class review: proton pump inhibitors: final report update 5. 2010.
Parikh N, Howden CW. The safety of drugs used in acid-related disorders and functional gastrointestinal disorders. Gastroenterology Clinics. 2010;39(3):529-42.
Mefford IN, Wade EU. Proton pump inhibitors as a treatment method for type II diabetes. Medical hypotheses. 2009;73(1):29-32.
Rickels MR, Elahi D. Raising serum gastrin to improve glycemic control in (type 2) diabetes: another limb of the enteroinsular axis? : Oxford University Press; 2012.
Suarez-Pinzon WL, Power RF, Yan Y, Wasserfall C, Atkinson M, Rabinovitch A. Combination therapy with glucagon-like peptide-1 and gastrin restores normoglycemia in diabetic NOD mice. Diabetes. 2008;57(12):3281-8.
Suarez-Pinzon W, Cembrowski G, Rabinovitch A. Combination therapy with a dipeptidyl peptidase-4 inhibitor and a proton pump inhibitor restores normoglycaemia in non-obese diabetic mice. Diabetologia. 2009;52(8):1680-2.
Boj Carceller D, Playán Usón J, Trincado Aznar P, Acha Pérez F, Albero Gamboa R. Proton pump inhibitors for the treatment of diabetes mellitus. Av Diabetol. 2010;26(1):45-6.
Boj-Carceller D, Bocos-Terraz P, Moreno-Vernis M, Sanz-Paris A, Trincado-Aznar P, Albero-Gamboa R. Are proton pump inhibitors a new antidiabetic drug? A cross sectional study. World journal of diabetes. 2011;2(12):217.
Hove KD, Færch K, Bödvarsdóttir TB, Karlsen AE, Petersen JS, Vaag A. Treatment with a proton pump inhibitor improves glycaemic control in type 2 diabetic patients-a retrospective analysis. Diabetes research and clinical practice. 2010;90(3):e72-e4.
Rajput MA, Ali F, Zehra T, Zafar S, Kumar G. The effect of proton pump inhibitors on glycaemic control in diabetic patients. Journal of Taibah University Medical Sciences. 2020;15(3):218-23.
Villegas K, Meier JL, Long M, Lopez J, Swislocki A. The effect of proton pump inhibitors on glycemic control in patients with type 2 diabetes. Metabolic syndrome and related disorders. 2019;17(4):192-6.
Kruszelnicka O, Kuźma M, Pena IZ, Perera IB, Chyrchel B, Wieczorek-Surdacka E, et al. No Association of Proton Pump Inhibitor Use with Fasting or Postload Glycaemia in Patients with Cardiovascular Disease: A Cross-Sectional Retrospective Study. International journal of medical sciences. 2017;14(10):1015.
Diabetes Statistics. American Diabetes Association.
Gómez-Izquierdo JC, Yu OHY. The influence of proton-pump inhibitors on glycemic control: a systematic review of the literature and a meta-analysis. Canadian journal of diabetes. 2017;41(4):351-61.
Crouch MA, Mefford IN, Wade EU. Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes. The Journal of the American Board of Family Medicine. 2012;25(1):50-4.
Matthews DR, Hosker J, Rudenski A, Naylor B, Treacher D, Turner R. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. diabetologia. 1985;28(7):412-9.
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