Antibiotic exposure and risk of type 2 diabetes mellitus: a systematic review and meta-analysis

To investigate the association between antibiotic exposure and risk of type 2 diabetes mellitus (T2DM). Four electronic databases, including PubMed, MEDLINE, EMBASE, and Cochrane Library, were searched for all relevant studies, from inception until May 2021, without restrictions. Pooled odds risk (OR) with 95% confidence intervals (CI) was applied to evaluate the effect value. Nine studies counting a total of 3,924,272 participants were assessed in the systematic review and meta-analyses. By meta-analysis using no antibiotic exposure as the reference, antibiotic exposure has a higher risk for T2DM (OR=1.16; 95% CI, 1.10-1.22). Subgroup analyses suggested that the antibiotic exposure could significantly enhance the risk of T2DM in those whose age were more than 50 (OR=1.17; 95% CI, 1.08-1.25). Further stratified analysis indicated that the association was likely attributed to the chemical structure of antibiotics, but not to antibacterial type and mechanism of action. Our results may further support the possibility that antibiotic use in recent years was associated with increased risk of T2DM. More attentions and cautions should be taken by the physicians when prescribing antibiotics.