Drugs and hyperglycemia: A practical guide.

Area of Science:

• Endocrinology
• Pharmacology
• Public Health

Background:

• Drug-induced diabetes contributes to the rising global incidence of diabetes.
• Numerous drug classes, including hormonal therapies, cardiovascular drugs, antipsychotics, and antiretrovirals, are implicated.
• The precise proximal defects in glucose regulation are not fully understood, complicating targeted treatment.

Purpose of the Study:

• To review the frequency, pathogenesis, and treatment of drug-induced diabetes.
• To highlight the underestimation of risk and potential reversibility of drug-induced diabetes.
• To identify knowledge gaps regarding long-term complications and inform clinical management strategies.

Main Methods:

• Comprehensive literature review of studies on drug-induced diabetes.
• Analysis of drug classes associated with hyperglycemia.
• Evaluation of current understanding of pathogenesis and treatment approaches.

Main Results:

• Identified key drug classes associated with diabetes, including glucocorticoids, statins, beta-blockers, diuretics, antipsychotics, and antiretrovirals.
• Highlighted that drug-induced diabetes involves decreased insulin secretion and insulin resistance, with proximal defects unknown.
• Noted that drug-induced diabetes is potentially reversible, but its risk is underestimated, and long-term complication data is limited.

Conclusions:

• Effective management requires awareness of drug diabetogenic potential, patient risk factors, and balancing drug benefits against risks.
• Standard diabetes care, including lifestyle changes and pharmacotherapy, is recommended in the absence of drug-specific guidelines.
• Further research is essential to elucidate pathophysiology and develop optimal, targeted treatments for drug-induced diabetes and its long-term sequelae.