Many pharmaceutical agents are known to cause impaired glucose tolerance and, occasionally, diabetes. Because some of these agents are widely used (e.g., thiazides, niacin), medication-associated hyperglycemia is not uncommon, especially in high-risk patients. Glucocorticoids can produce hyperglycemia by several mechanisms. Insulin resistance in the liver and muscle is a well-recognized effect of glucocorticoids. At higher doses, steroids also act on the beta cells to limit the compensatory response to hyperglycemia, which adds to their diabetogenic effect. Up to 25% of renal transplant patients develop so-called steroid diabetes. In a case-control study, use of glucocorticoids for up to 45 days was a risk factor for diabetes that required pharmacologic treatment. The odds ratio rose from 1.77 at a prednisone equivalent of 10 mg/day to an odds ratio of 10.3 at 30 mg/day.
Obesity and a family history of diabetes increased the risk of steroid diabetes. The atypical antipsychotic drugs are used extensively as mood stabilizers and are associated with a significantly increased risk of developing diabetes; for example, clozapine carries a risk of diabetes as much as seven times that of the classical antipsychotic agents.1 The use of anabolic steroids or growth hormones for bodybuilding purposes has been shown to worsen glucose metabolism.2 Some protease inhibitors used to treat HIV infection (e.g., indinavir, ritonavir) cause insulin resistance and diabetes.
For a current List of Drugs that can increase risk of Diabetes: Drugs That Increase Risk of Diabetes
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