title: Use of Antibiotics and Risk of Type 2 Diabetes: A Population-Based Case-Control Study.
abstract: OBJECTIVE
  Evidence that bacteria in the human gut may influence nutrient metabolism is accumulating. We investigated whether use of antibiotics influences the risk of developing type 2 diabetes and whether the effect can be attributed to specific types of antibiotics.
  
  
  METHODS
  We conducted a population-based case-control study of incident type 2 diabetes cases in Denmark (population 5.6 million) between January 1, 2000, and December 31, 2012. Data from the Danish National Registry of Patients, the Danish National Prescription Registry, and the Danish Person Registry were combined.
  
  
  RESULTS
  The odds ratio (OR) associating type 2 diabetes with exposure to antibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) with redemption of more than or equal to 5 versus 0-1 prescriptions. Although no individual group of antibiotics was specifically associated with type 2 diabetes risk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum and bactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum and bacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A clear dose-response effect was seen with increasing cumulative load of antibiotics. The increased use of antibiotics in patients with type 2 diabetes was found up to 15 years before diagnosis of type 2 diabetes as well as after the diagnosis.
  
  
  CONCLUSIONS
  Our results could support the possibility that antibiotics exposure increases type 2 diabetes risk. However, the findings may also represent an increased demand for antibiotics from increased risk of infections in patients with yet-undiagnosed diabetes.
authors: Center for Diabetes Research (K.H.M., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup; Novo Nordisk Foundation Center for Basic Metabolic Research (K.H.M., F.K.K.), Department of Biomedical Sciences, University of Copenhagen, Denmark; Department of Medicine (M.F.), Kolding Hospital, Kolding, Denmark; Endocrine Research Unit (M.F.), University of Southern Denmark, Odense, Denmark; and Clinical Pharmacology (J.H., A.P.), Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Kristian Hallundbæk
authors: KH
authors: Mikkelsen
authors: Center for Diabetes Research (K.H.M., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup; Novo Nordisk Foundation Center for Basic Metabolic Research (K.H.M., F.K.K.), Department of Biomedical Sciences, University of Copenhagen, Denmark; Department of Medicine (M.F.), Kolding Hospital, Kolding, Denmark; Endocrine Research Unit (M.F.), University of Southern Denmark, Odense, Denmark; and Clinical Pharmacology (J.H., A.P.), Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Filip Krag
authors: FK
authors: Knop
authors: Center for Diabetes Research (K.H.M., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup; Novo Nordisk Foundation Center for Basic Metabolic Research (K.H.M., F.K.K.), Department of Biomedical Sciences, University of Copenhagen, Denmark; Department of Medicine (M.F.), Kolding Hospital, Kolding, Denmark; Endocrine Research Unit (M.F.), University of Southern Denmark, Odense, Denmark; and Clinical Pharmacology (J.H., A.P.), Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Morten
authors: M
authors: Frost
authors: Center for Diabetes Research (K.H.M., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup; Novo Nordisk Foundation Center for Basic Metabolic Research (K.H.M., F.K.K.), Department of Biomedical Sciences, University of Copenhagen, Denmark; Department of Medicine (M.F.), Kolding Hospital, Kolding, Denmark; Endocrine Research Unit (M.F.), University of Southern Denmark, Odense, Denmark; and Clinical Pharmacology (J.H., A.P.), Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Jesper
authors: J
authors: Hallas
authors: Center for Diabetes Research (K.H.M., F.K.K.), Gentofte Hospital, University of Copenhagen, Hellerup; Novo Nordisk Foundation Center for Basic Metabolic Research (K.H.M., F.K.K.), Department of Biomedical Sciences, University of Copenhagen, Denmark; Department of Medicine (M.F.), Kolding Hospital, Kolding, Denmark; Endocrine Research Unit (M.F.), University of Southern Denmark, Odense, Denmark; and Clinical Pharmacology (J.H., A.P.), Department of Public Health, University of Southern Denmark, Odense, Denmark.
authors: Anton
authors: A
authors: Pottegård
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016022:Case-Control Studies; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012042:Registries; D012306:Risk
chemical_list: D000900:Anti-Bacterial Agents