Effect of diuretic use on the development of diabetes mellitus. The Framingham study

The hypothesis that diuretic use may increase the risk of diabetes mellitus was prospectively examined in men and women aged 50 years and over in the Framingham study. Age-adjusted relative risk estimates were calculated comparing the rate of diabetes among those who took diuretics to those who did not take these medications. The relative risks (95% confidence limits) were statistically elevated (P less than 0.05) in both sexes; 2.1 (1.2, 3.6) in men and 2.5 (1.4, 4.5) in women. After covariate adjustment for body mass index, concentrations of total cholesterol, high density lipoprotein cholesterol, very low density cholesterol, systolic blood pressure, and cigarette smoking the relative risks were no longer statistically significant; 1.2 (0.6, 2.4) for men and 1.6 (0.8, 3.2) for women. These results are suggestive of a possible deleterious affect of diuretic use particularly in women and indicate that persons receiving diuretic agents should be carefully monitored for adverse changes in other risk factors.