Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes.
BACKGROUND
Oral hypoglycemic medications sometimes do not control type 2 diabetes well. Proton pump inhibitors (PPIs) as adjunctive therapy might improve diabetes control through increasing serum gastrin and fasting insulin levels.


METHODS
Electronic medical records in a family medicine residency program office practice were reviewed for 73 individuals with type 2 diabetes (not taking insulin), for whom PPIs were prescribed. Values for glycosylated hemoglobin (HbA1c) for periods of time when a PPI had been prescribed were compared with HbA1c levels for periods of time with no record of PPI prescribing or over-the-counter PPI use.


RESULTS
The mean HbA1c for patients not taking insulin was 7.11 during periods with recorded prescribing or over-the-counter use of PPIs, compared with 7.70 during periods without recorded PPI therapy (P = .001). Mean HbA1c for metformin monotherapy was not significantly different (6.81 with PPI vs. 7.10 without PPI; n = 16; P = .25). Mean HbA1c was significantly different for combination therapy that included metformin and/or sulfonylurea and/or giltazone (7.26 vs. 7.80; n = 27; P = .002).


CONCLUSIONS
The observed association between PPI therapy and lower HbA1c levels suggests that PPIs may be useful as adjunctive therapy for type 2 diabetes.
Memorial Family Medicine Residency Program, Sugar Land, Texas, USA. michael.crouch@memorialhermann.org
Michael A
MA
Crouch
Ivan N
IN
Mefford
Ekpedeme U
EU
Wade
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D057286:Electronic Health Records; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis / Q000187:drug effects*; D006764:Hospitals, Community; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D008297:Male; D008485:Medical Audit; D008687:Metformin / Q000627:therapeutic use; D008875:Middle Aged; D054328:Proton Pump Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use*; D012189:Retrospective Studies
D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D008687:Metformin; D054328:Proton Pump Inhibitors