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Antibiotics Possibly Linked to Increased Risk of Diabetes

Extended, multiple, or lifetime regimens of medications may alter gut micobiota…

With increased prevalence of antibiotics, researchers are constantly learning new information about the effects of these drugs. It is known that gut microbiota can influence metabolic pathways affecting the pathogenesis of obesity and insulin resistance. According to researchers, patients prescribed multiple courses of antibiotics may be at increased risk for type 1 and type 2 diabetes due to alterations in gut microbiota.

The primary endpoint of the study was to determine whether past antibiotic exposure increases the risk of acquiring diabetes. The researchers utilized a nested case-control study using the Health Improvement Network (THIN), a United Kingdom population-based database. The cases were defined as those with incident diagnosis of diabetes, with every case having four eligible controls based on age, sex, practice-site, and duration of follow-up before index-date were selected using incidence –density sampling. All cases with prediabetes or undiagnosed diabetes were excluded from the study. From the database, researchers were able to select 204,002 diabetes patients and 815,576 controls matched. The exposure of interest was antibiotic therapy greater than a year before index-date. The odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using conditional logistic regression.

It was found that exposure to a single antibiotic drug was not associated with a higher risk of diabetes. However, treatment with 2-5 antibiotic courses showed an increased diabetes risk for penicillin, cephalosporins, macrolides, and quinolones with an adjusted OR ranging from 1.08 for penicillin and 1.15 for quinolones. There was also an increased risk of diabetes found in those patients taking more than five courses of tetracyclines. The highest risk for diabetes was seen in those patients received greater than five courses of quinolones with an adjusted OR of 1.21.

Researchers concluded that extended exposure to certain antibiotic classes can lead to an increase in diabetes risk.

Practice Pearls:

  • Special attention should be paid to patients on extended, multiple, or lifetime regimens of antibiotics.
  • Alternative drugs to those shown to increase risk of diabetes should be used, if possible, in patients increased risk factors for diabetes.
  • Educate all patients on multiple regimens of antibiotics on the importance of a proper diet and exercise regimen.

Ben Boursi. “The Effect of past Antibiotic Exposure on Diabetes Risk.” (2015): 14-1163. 23 Apr. 2015. Web. 8 May 2015.