General Warnings

List of Drugs That Can Cause Diabetes

What is diabetes?

Diabetes happens when your body isn’t able to take up sugar (glucose) into its cells and use it for energy. This results in a build up of extra sugar in your bloodstream. In 2014, 8.5% of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths.

Poorly controlled diabetes can lead to serious consequences, causing damage to a wide range of your body’s organs and tissues – including your heart, kidneys, eyes and nerves.

Drugs That Can Cause Diabetes

What is drug induced diabetes?

Drug induced diabetes is when use of a specific medication has lead to the development of diabetes. In some cases the development of diabetes may be reversible if use of the medication is discontinued, but in other cases drug-induced diabetes may be permanent.

Drug-induced hyperglycaemia increases the risk of microvascular and macrovascular complications, infections, metabolic coma and even death. Drugs may induce hyperglycaemia through a variety of mechanisms, including alterations in insulin secretion and sensitivity, direct cytotoxic effects on pancreatic cells and increases in glucose production.

Studies have shown that drugs which commonly cause diabetes during therapeutic use are the anti-hypertensive vasodilator diazoxide, and corticosteroids in high doses such as those used to palliate intracranial tumours. The full list of drugs that can increase glucose levels and cause diabetes are presented in the table below: 

FluoroquinolonesGatifloxacin (not available in United States), moxifloxacinAltered insulin secretion. Association with moxifloxacin is rare.
HIV antiretroviralsProtease inhibitors Nucleoside reverse transcriptase inhibitors (NRTIs)Increased peripheral insulin resistance. Part of antiretroviral-associated metabolic syndrome.
Other anti-infectivesPentamidineAltered pancreatic beta cell function. Following initial hypoglycemic effect, beta cell destruction can occur.
First-generationChlorpromazine, perphenazine, other phenothiazinesMechanism not established. Appears to involve increased insulin resistance and diminished insulin secretion.
Second-generationClozapine, iloperidone, olanzapine, paliperidone, quetiapine, risperidoneMechanism not established. Appears to involve increased insulin resistance and diminished insulin secretion.
Beta blockersAtenolol, metoprolol, propranololDecreased insulin sensitivity (moderate effect). Carvedilol does not appear to impair glucose tolerance. Refer to UpToDate topic on treatment of hypertension in patients with diabetes mellitus.
HypolipidemicNiacin (nicotinic acid), statinsNiacin – Altered hepatic glucose metabolism, probably greater with extended-release form. Statins – Evidence of impaired glucose tolerance due to statins is conflicting, and overall risk appears low.
Thiazide diureticsHydrochlorothiazide, chlorthalidone, chlorothiazide, indapamideReduced total-body potassium, decreased insulin secretion, and increased insulin resistance[2]. Infrequent with low dosages (ie, hydrochlorothiazide ≤25 mg or equivalent). Potassium supplementation may decrease thiazide-associated glucose intolerance.
VasodilatorsDiazoxideReduced insulin secretion and sensitivity, increased hepatic glucose production.
VasopressorsEpinephrine, norepinephrineActivation of glycogenolysis, increased hepatic gluconeogenesis, stimulation of glucagon and cortisol, inhibition of insulin secretion.
Gonadotropin-releasing hormone agonistsClass effect in males receiving androgen deprivation therapy for metastatic prostate cancerRefer to UpToDate topic on side effects of androgen deprivation therapy.
Glucocorticoids, systemic* NOTE: Glucocorticoids are a particularly common cause of clinically significant drug-induced hyperglycemiaClass effectMultifactorial, including increased hepatic glucose production, increased insulin resistance, increased expression of peroxisome proliferator activated gamma receptors (PPAR-gamma). Refer to UpToDate topic on major side effects of systemic glucocorticoids.
Hormones, sex
Oral contraceptivesCombination estrogen-progestin oral contraceptives, progestin-only contraceptivesAltered hepatic glucose metabolism, increased peripheral insulin resistance. Low-dose pills (≤35 mcg ethinyl estradiol) have little effect on carbohydrate metabolism in most females. Refer to UpToDate topics on pregnancy evaluation and management of females with diabetes mellitus.
ProgestinMegestrol acetate
Hormones, growthSomatropin, tesamorelinIncreased counterregulatory responses. Refer to Up To Date topics on treatment of growth hormone deficiency and treatment of HIV-associated lipodystrophy.
ImmunosuppressantsCyclosporine (cyclosporin), sirolimus, tacrolimusDecreased insulin synthesis and release. Refer to UpToDate topic on new-onset diabetes after transplant in renal transplant recipients.

Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
Back to top button

Adblock Detected

Please consider supporting us by disabling your ad blocker