Drug-Induced Hyperglycaemia and Diabetes

Area of Science:

• Endocrinology and Pharmacology
• Metabolic Disorders
• Drug Safety

Background:

• Drug-induced hyperglycemia and diabetes represent a significant global health issue.
• These conditions elevate the risk of severe complications, including microvascular and macrovascular issues, infections, metabolic coma, and mortality.
• Medications can induce hyperglycemia via diverse mechanisms, affecting insulin secretion, sensitivity, pancreatic cell function, and glucose production.

Purpose of the Study:

• To review the various drug classes associated with inducing hyperglycemia.
• To elucidate the mechanisms through which different medications alter glucose metabolism.
• To emphasize the importance of clinical awareness and monitoring for drug-induced hyperglycemia.

Main Methods:

• Literature review of drugs known to cause hyperglycemia.
• Categorization of implicated drug classes, including antihypertensives, lipid-modifying agents, anti-infectives, antipsychotics, and others.
• Summary of proposed mechanisms for hyperglycemia induction by each drug class.

Main Results:

• Antihypertensives (thiazide diuretics, beta-blockers) and lipid-modifying agents (statins, nicotinic acid) are frequently implicated.
• Anti-infectives (fluoroquinolones, protease inhibitors), antidiabetics, antipsychotics, and glucocorticoids are also associated with hyperglycemia.
• Specific mechanisms include impaired insulin secretion/sensitivity, pancreatic cell toxicity, and increased glucose production.

Conclusions:

• A wide array of medications can induce hyperglycemia, with varying mechanisms and risk levels.
• Clinicians must be vigilant regarding medications that can alter glycemic control.
• Proactive identification and close monitoring of patients on potentially diabetogenic drugs are crucial for preventing adverse outcomes.