Long-term use of a group of commonly used drugs for acid reflux (heartburn) — known as proton pump inhibitors (PPIs) — is linked to an increased risk for type 2 diabetes, according to a new study published in the Journal of Clinical Endocrinology & Metabolism.
Some previous studies have also shown a heightened diabetes risk linked to PPIs — which include drugs such as Prilosec (omeprazole), Nexium (esomeprazole), Prevacid (lansoprazole), and Protonix (pantoprazole). But the evidence has been somewhat contradictory. One analysis published a couple of years ago showed that in a long-term study of health care workers called the Nurses’ Health Study, people who took PPIs for over 2 years were 26% more likely to develop type 2 diabetes over a follow-up period averaging 10 years. But another study, published last year, found that in people who already had diabetes, taking PPIs was found to help improve blood glucose control, improving participants’ A1C level (a measure of long-term blood glucose control) by an average of 0.36%.
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For the latest study, researchers in Lombardy, Italy, looked at a group of 777,420 participants without diabetes who started taking PPIs between 2010 and 2015. This study followed what is known as a case-control design, which means that the 50,535 participants who developed diabetes over the course of the follow-up period (until 2020) were compared with an equal number of participants who didn’t develop diabetes, who were randomly selected and matched based on age, sex, and health factors. The researchers could then compare exposure to PPIs between participants who did and didn’t develop diabetes, based on when they started taking the drug and how long they took it.
Longer duration of PPI use linked to higher type 2 diabetes risk
The researchers found that compared with participants who took a PPI for less than eight weeks, those who took the drug for between eight weeks and six months were 19% more likely to develop diabetes. Those who took a PPI for between six months and two years were 43% more likely to develop diabetes, and those who took a PPI for longer than two years were 56% more likely to develop diabetes. These results stayed fairly consistent when participants were grouped according to age, sex, and health status — although younger participants and those with more complicated health conditions tended to see their risk for diabetes increase by a greater amount if they took a PPI.
The researchers concluded that consistent with previous studies, regular and prolonged use of PPIs is linked to a higher risk of developing type 2 diabetes. Doctors, they wrote, should avoid unnecessarily prescribing these drugs for acid reflux, particularly for use over a prolonged period of time.
Want to learn more about acid reflux? Read “Lifestyle Changes to Manage Acid Reflux.”