title: Impact of chronic diuretic treatment on glucose homeostasis.
abstract: BACKGROUND
  The use of diuretics for hypertension has been associated with unfavorable changes in cardiovascular risk factors, such as uric acid and glucose tolerance, though the findings in the literature are contradictory.
  
  
  METHODS
  This study investigated whether diuretic use is associated with markers of metabolic and cardiovascular risk, such as insulin-resistance and uric acid, in a cohort of adults without known diabetes and/or atherosclerotic cardiovascular disease. Nine hundred sixty-nine randomly selected participants answered a questionnaire on clinical history and dietary habits. Laboratory blood measurements were obtained in 507 participants.
  
  
  RESULTS
  Previously undiagnosed type 2 diabetes was recognized in 4.2% of participants who were on diuretics (n = 71), and in 2% of those who were not (n = 890; P = 0.53). Pre-diabetes was diagnosed in 38% of patients who were on diuretics, and in 17.4% (P < 0.001) of those who were not. Multivariate analysis showed that insulin-resistance (HOMA-IR) was associated with the use of diuretics (P = 0.002) independent of other well-known predisposing factors, such as diet, physical activity, body mass index, and waist circumference. The use of diuretics was also independently associated with fasting plasma glucose concentrations (P = 0.001) and uric acid concentrations (P = 0.01).
  
  
  CONCLUSIONS
  The use of diuretics is associated with insulin-resistance and serum uric acid levels and may contribute to abnormal glucose tolerance.
authors: Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS) - Laboratorio di Nutrizione Clinica, University of Palermo, Via del Vespro, 129, Palermo 90127, Italy. silbus@tin.it.
authors: Silvio
authors: S
authors: Buscemi
authors: Antonio
authors: A
authors: Nicolucci
authors: Giuseppe
authors: G
authors: Lucisano
authors: Fabio
authors: F
authors: Galvano
authors: Giuseppe
authors: G
authors: Grosso
authors: Fatima M
authors: FM
authors: Massenti
authors: Emanuele
authors: E
authors: Amodio
authors: Alice
authors: A
authors: Bonura
authors: Delia
authors: D
authors: Sprini
authors: Giovam B
authors: GB
authors: Rini