July 2, 2021 – A class of drugs widely used to treat heartburn and stomach ulcers improves blood sugar control in patients with diabetes when used in addition to their usual treatment, shows a new analysis.
But the same class of drugs – known medically as proton pump inhibitors (PPIs), and including drugs like omeprazole – didn’t prevent diabetes in people who didn’t already have it, the same research shows.
Not only do we know that these drugs affect certain gut hormones that are important for glucose regulation, ”Kashif Munir, MD, told WebMD.
“So if someone is already on a PPI and they are fine, it gives them confirmation that the PPIs could also be helpful for their diabetes if they have one,” he said.
The study was published online in the Journal of Clinical Endocrinology & Metabolism on June 25, 2021.
Antacids lowered two diabetes measures
Munir, Associate Professor of Endocrinology, Diabetes, and Nutrition at the University of Maryland Medical School at Baltimore, and colleagues examined the results of five studies involving nearly 250,000 people without diabetes. The researchers did not find that using proton pump inhibitors reduced the risk of developing new diabetes in this population group.
But then they looked at seven studies that included 342 patients with diabetes to see the effects of PPIs on blood sugar control.
“Overall, PPI therapy as a supplement to standard therapy was associated with an additional 0.36% decrease in glycosylated hemoglobin (HbA1c) compared to standard therapy,” they report.
Glycated hemoglobin is a measure of a patient’s average blood sugar level for the past 2 to 3 months, and values of 6.5% or more on two separate tests are diagnostic of diabetes.
And while a 0.36% reduction in A1c may sound modest, the FDA is considering hypoglycemic drugs for approval if they lower A1c by just 0.3%, Munir noted.
Similarly, adding PPIs to standard anti-diabetic treatment was associated with an additional, albeit modest, decrease in fasting blood sugar by 10.0 milligrams per deciliter (mg / dL).
The researchers found that the higher the PPI dose, the better the blood sugar-lowering effect.
And patients who had poor blood sugar control – which was reflected in a higher A1c – benefited more from taking the antacids than those whose diabetes was initially well controlled.
The effects of proton pump inhibitor antacids on glycemic control “should be considered when prescribing antacids to patients with diabetes,” the researchers conclude.
“If you are someone [with diabetes] heartburn sufferers, the PPIs could be seen as a potentially beneficial therapy for treating both conditions with one drug, ”Munir said.
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Kashif Munir, MD, Associate Professor of Endocrinology, Diabetes, and Nutrition, University of Maryland School of Medicine, Baltimore.
The Journal of Clinical Endocrinology & Metabolism, “Effects of Proton Pump Inhibitors on Glycemic Control and Diabetes Incidence: A Systematic Review and Meta-Analysis.”
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