We all know that prescription drugs come with a variety of side effects in some people. Things like tummy upsets, constipation, headaches, drowsiness, dizziness and nausea are fairly common.
What most of us don’t think about when handed a prescription by our doctor is that the medicine could set us on the path towards metabolic syndrome and type 2 diabetes. Yet, that is the shocking truth; not for some rarely prescribed drug for a condition you’ve never heard of, but for whole classes of commonly prescribed medications that together make up the vast majority of prescriptions written in the UK.
Two major recent studies showed that statins, the world’s best-selling drugs, were clearly implicated in increasing the risk of type 2 diabetes. Statins block the production of cholesterol in the liver, but in doing so they also block the production of a related substance called dolichol, which has an important role in sugar metabolism and insulin sensitivity. The sad fact is that, while they increase the risk of diabetes, statins actually do little or nothing to reduce the risk of a heart attack, the reason they were prescribed in the first place.
A class of frequently prescribed steroid drugs called glucocorticoids (such as prednisolone) are also known to affect blood sugar control and lead to type 2 diabetes. The medical community is well aware of “steroid diabetes” as a condition that arises in people who have to take these drugs for an extended period, such as kidney transplant patients. But if your GP prescribes you a glucocorticoid for your asthma, eczema or irritable bowel syndrome, you may not be warned of this risk. Glucocorticoids raise blood sugar levels by promoting insulin resistance in the liver and muscle cells. At higher doses, they also impair the function of insulin producing beta cells in the pancreas, reducing the release of insulin.
Another mainstay of drug based medicine, beta blockers are used to treat a wide variety of conditions, including high blood pressure, angina, abnormal heart rhythm, overactive thyroid, glaucoma, anxiety and migraine. These drugs not only increase blood sugar levels in those who don’t have diabetes, but may worsen blood sugar control in people with diabetes and also blunt the warning symptoms when hypoglycaemia occurs. A massive study involving nearly 20,000 patients established a clear connection between the use of older beta blocker drugs, such as atenolol and type 2 diabetes.
Several studies have linked the long term use of antidepressants, one of the most frequently prescribed kinds of medication in the UK, with a raised risk of type 2 diabetes. All types of antidepressants, including tricyclic and SSRIs, are implicated. A recent major study, which examined the health data of more than 168,000 people, concluded that, even after adjusting for weight gain (a common side effect of antidepressants), people taking these drugs had an elevated risk of type 2 diabetes.
The list goes on and on…..
Other classes of drugs have also been linked with raised blood sugar levels, metabolic syndrome or type 2 diabetes.
- Blood pressure drugs, which a long term study found was associated with new onset diabetes in 20% of patients who took them and with a consequent increased risk of heart attack and stroke in these patients.
- Diuretics, particularly the thiazide type, which reduce blood potassium levels and interfere with the release of insulin by the pancreas.
- Mood stabilisers, such as clozapine, quetiapine and risperidone, which have been found to cause metabolic syndrome, including raised blood sugar and blood fat levels, abdominal obesity and high blood pressure.
- Anti-epilepsy drug sodium valproate (Epilim), which is often also prescribed for bipolar disorder and can interfere with the mechanism by which cells take up glucose, leading to raised blood sugar levels.
I get the feeling we have only just scratched the surface and that prescription drugs could turn out to be a significant factor in the worldwide epidemic of metabolic syndrome and diabetes. Big Pharma must be well aware of this, but why would they tell anybody about it when sales of anti-diabetic drugs are such a big earner for them?
If you already have diabetes or metabolic syndrome, it is vital that you are aware of the damage that the drugs mentioned above could do to your blood sugar control. Ask your doctor how any medications you are taking could affect your glucose metabolism (doubt he will know). Sometimes it is a case of weighing one risk against another, but often there are safer drugs or non-drug alternatives that can be just as effective. Just don’t stop any medication without letting your doctor know.
NB Do not follow Diabetes UK or the American Diabetes Association’s recommendations for diabetes control; they are highly flawed due to vested or conflicting interests.