Exposure to proton pump inhibitors and risk of diabetes: A systematic review and meta-analysis

Guo, Yun-Ran; Liu, Xinming; Wang, Guixia

doi:10.4239/wjd.v14.i2.120

Cited by 4 publications

(2 citation statements)

References 33 publications

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“…Enterococcus growth in the intestines translocating into the liver and inducing inflammation may contribute to chronic liver diseases 43 . Beyond the gastrointestinal realm, the derived hypomagnesemia and reduced insulin-like growth factor-1 (IGF-1) levels might facilitate diabetes mellitus development 44 . PPIs’ impact on enteric infection, along with hypomagnesemia and uremic toxin accumulation, may contribute to CKD 45 .…”

Section: Discussionmentioning

confidence: 99%

Individualized prevention of proton pump inhibitor related adverse events by risk stratification

Xia,

He,

Smith

et al. 2024

Nat Commun

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Proton pump inhibitors (PPIs) are commonly used for gastric acid-related disorders, but their safety profile and risk stratification for high-burden diseases need further investigation. Analyzing over 2 million participants from five prospective cohorts from the US, the UK, and China, we found that PPI use correlated with increased risk of 15 leading global diseases, such as ischemic heart disease, diabetes, respiratory infections, and chronic kidney disease. These associations showed dose-response relationships and consistency across different PPI types. PPI-related absolute risks increased with baseline risks, with approximately 82% of cases occurring in those at the upper 40% of the baseline predicted risk, and only 11.5% of cases occurring in individuals at the lower 50% of the baseline risk. While statistical association does not necessarily imply causation, its potential safety concerns suggest that personalized use of PPIs through risk stratification might guide appropriate decision-making for patients, clinicians, and the public.

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Section: Discussionmentioning

confidence: 99%

Individualized prevention of proton pump inhibitor related adverse events by risk stratification

Xia,

He,

Smith

et al. 2024

Nat Commun

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“…В метаанализ китайских ученых вошли 9 исследований с общим числом участников 867 185 человек [38]. Результаты показали, что применение ИПП увеличивает риск развития СД (ОШ 1,23, 95% ДИ 1,05-1,43).…”

Section: сахарный диабетunclassified

Cardiovascular risk with long-term use of proton pump inhibitors: myth or reality. A review

Trukhan,

Filimonov

2024

Consilium Medicum

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Proton pump inhibitors (PPIs) are the most effective drugs for treating acid-related diseases. In recent decades, the use of PPIs has increased exponentially. From gastroenterological practice, PPIs are being actively introduced into other specialties, in particular in cardiology and rheumatology, where they are used to protect the mucous membrane of the gastrointestinal tract and prevent gastrointestinal bleeding during long-term antithrombotic therapy and long-term use of non-steroidal anti-inflammatory drugs. For a long time, PPIs were considered completely safe drugs for both short-term and long-term use. However, modern clinical guidelines note that when prescribing PPIs in large doses for a long period, the possibility of side effects should be taken into account. In recent years, a number of foreign reviews have been published that examine the relationship between PPIs and a number of diseases/conditions, including the question of a possible association of PPI use with an increased risk of cardiovascular complications, but note the inconsistency of these data. We searched the PubMed and Scopus information databases for publications on the safety of PPI use, including sources up to 12/01/2023. In this review, we examined the possible cardiovascular risk of long-term use of PPIs. Analysis of publications, despite a number of contradictions, allows us to conclude that the cardiovascular risk with long-term use of PPIs is real and must be taken into account when prescribing PPIs for a long period and to comorbid/multimorbid patients.

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Association and Mechanisms of Proton Pump Inhibitors Use with Type-2 Diabetes Mellitus Incidence in Adults: A Systemic Review and Meta-Analysis

Chenchula,

Sharma,

Ghanta

et al. 2024

CDR

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Background: Proton pump inhibitors (PPIs) are an extensively prescribed class of anti-ulcer drugs. This systematic review aimed to investigate the association between PPI use and the risk of new-onset diabetes mellitus or type 2 diabetes (T2DM) incidence. Methods: A comprehensive literature search was conducted in PubMed, Scopus, Cochrane Library, and ClinicalTrials.gov using the search terms “proton pump inhibitor,” “proton pump inhibitors,” “PPIs,” “diabetes mellitus,” and “type 2 diabetes” from inception to February 2023. Statistical analyses were performed using the “Review Manager 5.4” version, and a statistically highly significant P value <0.05 was set. Results: This systematic review identified 12 studies (8 cohort, 1 RCT, and 3 case-control) with a total of 12, 64, 816 population, and the median age ranged from ≥18 yrs to ≤ 75 yrs. The pooled relative risk (RR) observations of a random-effects meta-analysis model showed that chronic exposure to PPI use has a significant association with T2DM risk incidence (RR, 2.44; 95% confidence interval, 1.31–4.54; I 2 = 99%, P < 0.00001). The systematic review findings of the three case-control studies also supported an association of dose-dependent and chronic use of PPIs with an incidence of T2DM among chronic users. Conclusion: The systematic review concludes that chronic PPI exposure increases the risk of T2DM incidence. The authors recommend the shortest possible duration of PPI use and not prescribing PPIs to high-risk prediabetics and those without a compelling indication for PPI use. Regular education to patients regarding adverse reactions with prolonged use may decrease the risk of adverse effects associated with PPIs. The authors suggest that gut dysbiosis, hypergastrinemia, hypomagnesemia, decreased pancreatic secretions and IGF-1 levels, and PXR activation associated with chronic acid suppression among chronic PPI users and the potency of PPIs might explain the association between abnormal glucose metabolism and T2DM incidence. Finally, the authors recommend further randomized controlled trials to investigate the association between PPIs and the risk of new-onset T2DM incidence.

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Exposure to proton pump inhibitors and risk of diabetes: A systematic review and meta-analysis

Cited by 4 publications

References 33 publications

Individualized prevention of proton pump inhibitor related adverse events by risk stratification

Individualized prevention of proton pump inhibitor related adverse events by risk stratification

Cardiovascular risk with long-term use of proton pump inhibitors: myth or reality. A review

Association and Mechanisms of Proton Pump Inhibitors Use with Type-2 Diabetes Mellitus Incidence in Adults: A Systemic Review and Meta-Analysis

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