July 2, 2021 – A class of drugs widely used to treat heartburn and stomach ulcers improves blood sugar control in patients with diabetes when added to their usual treatment, according to a new analysis.
But the same class of drugs – known medically as proton pump inhibitors (PPIs) and including agents like omeprazole – didn’t prevent diabetes in people who don’t already have it. , shows the same search.
In addition to working to suppress acid, “We know that these drugs affect certain gut hormones that are important in regulating glucose,” Kashif Munir, MD, told WebMD.
“So if someone is already on PPI and is doing well, it gives them the recognition that PPIs could also be helpful for their diabetes if they have it,” he said.
The study was published online on June 25, 2021 in The Journal of Clinical Endocrinology & Metabolism.
Antacids reduced two measures of diabetes
Munir, associate professor of endocrinology, diabetes, and nutrition at the University of Maryland, Baltimore School of Medicine, and his colleagues looked at the results of five studies involving nearly 250,000 people without diabetes. The researchers did not find that the use of proton pump inhibitors reduced the risk of developing new diabetes in this population.
But then they looked at seven studies involving 342 diabetic patients to see the effects of PPIs on blood sugar control.
“Overall, PPI treatment as an add-on to standard care was associated with an additional 0.36% decrease in glycosylated hemoglobin (HbA1c) compared to standard therapy,” they report.
Glycosylated hemoglobin is a measure of a patient’s average blood sugar over the past 2-3 months, and levels of 6.5% or more on two separate tests are diagnostic for diabetes.
And while a 0.36% reduction in A1c may seem modest, the FDA is considering approving hypoglycemic drugs if they reduce A1c by as little as 0.3%, noted Munir.
Likewise, the use of PPI in addition to standard diabetes therapy was associated with an additional, albeit modest, reduction of 10.0 milligrams per deciliter (mg / dL) in fasting blood sugar.
The higher the dose of PPI, the better the blood sugar lowering effect, according to the researchers.
And patients who had poor blood sugar control – reflected in higher A1c levels – benefited more from taking antacids than those whose diabetes was well controlled to begin with.
The effects of proton pump inhibitor antacids on blood sugar control “should be taken into account when prescribing antacids to diabetic patients,” the researchers conclude.
“If you are someone [with diabetes] who suffers from heartburn, PPIs could be seen as a potentially beneficial therapy to treat both conditions with one drug, ”Munir said.