It’s common knowledge that excess weight, a large waist circumference, a poor diet, and inactivity are risk factors for type 2 diabetes. But did you know that a number of popular drugs also increase risk?
Statin Drugs & Diabetes Risk
Statin drugs are among the best-selling medications in the history of Big Pharma. Since Lipitor hit the market in 2003, this cholesterol-lowering drug has been joined by dozens of other brand-name and generic statins, which are taken by 35 million Americans and rack up annual global sales of $20 billion.
But statins have a dark side.
In addition to well-known side effects of muscle pain, weakness, and cognitive problems, statin drugs can cause diabetes mellitus. This adverse effect is significant enough that the FDA requires all statins to include a label warning that they increase the risk of elevated blood sugar.
How Can Statin Drugs Cause Diabetes?
The statin-diabetes link was demonstrated in a 2019 study that involved nearly 5,000 participants who, based on their risk profile, were considered to be good candidates for statin drugs. Findings include:
- People who took a statin were more than twice as likely to be diagnosed with diabetes compared to those of similar age, weight, etc., who were not on the drugs.
- Risk was dose-dependent. Individuals who took a statin for more than two years had a three-fold increased risk of developing diabetes.
- A “possible reason” is because statins decrease coenzyme Q10 (CoQ10) production, leading to mitochondrial dysfunction and energy depletion that impairs glucose transport and insulin sensitivity.
Folks, CoQ10 depletion is more than a “possible reason.” It is a proven adverse effect that is also linked with muscle pain, memory loss, and other disturbingly common statin side effects.
Antipsychotics, Weight Gain & Diabetes
Antipsychotic drugs were originally used to treat schizophrenia and psychosis (loss of contact with reality, e.g., hallucinations and delusions). Over the years, however, the FDA has broadened approved uses to include patients with bipolar disorder; children with schizophrenia, bipolar, and autism; and adults with depression as an add-on to antidepressant.
Zyprexa, Abilify, Seroquel, and other antipsychotics are notorious for increasing appetite and packing on the pounds. Up to 30% of adults and children who take these drugs have “clinically significant” weight gain. Studies show that one in five people who take Zyprexa—which appears to have the greatest impact on weight—for more than two years gain more than 33 pounds!
These drugs also increase the risk of diabetes. Although much of this risk can be attributed to drug-induced weight gain, antipsychotics are also linked with serious metabolic abnormalities, including insulin resistance, elevated blood sugar, and lipid abnormalities. All these signs and symptoms of metabolic syndrome dramatically increase the likelihood of developing not only diabetes but also cardiovascular disease.
Although these medications are an invaluable treatment for serious mental illness, there is general agreement that they are overused for patients with mild to moderate depression, developmental disorders, and dementia. Therefore, it’s important to weight the risks against the benefits.
Long-Term Use of Corticosteroids
Prednisone and other corticosteroids are powerful medications that curb inflammation and dampen the immune response. Because acute and chronic inflammation underlie many health challenges, corticosteroids have multiple uses, ranging from asthma and allergies to osteoarthritis and tendinitis to lupus and other autoimmune diseases.
Depending on the mode of delivery and duration of use, corticosteroids can have serious side effects—and one of them is an increased risk of diabetes. Injected into painful joints or muscles, inhaled to reduce asthma flareups, used topically for skin conditions, or taken orally for a short time to treat pain and inflammation, corticosteroids are not associated with diabetes.
Prolonged use of oral corticosteroids, however, has serious adverse effects, including elevations in blood sugar and insulin resistance. Taking these medications for longer than three months—which is necessary for some diseases—increases the risk of developing not only diabetes but also hypertension, fluid retention, weight gain, mood swings, osteoporosis, and cataracts. If you must be on a corticosteroid over the long term, make sure your doctor monitors you carefully.
Other Drugs That Can Increase Risk
Other medications have also been shown to increase the risk of developing type 2 diabetes or worsen blood sugar in patients already diagnosed with diabetes. They include:
- Beta blockers, used to treat hypertension and other cardiovascular conditions
- Thiazide diuretics, also prescribed for high blood pressure
- Birth control pills
- Protease inhibitors, used to treat HIV, hepatitis C, and other viral infections
Medication Risks With Other Types of Diabetes
So far, we have focused on type 2 diabetes, which affects 90–95% of all diabetics. What about other types?
- It is unlikely that drugs can cause type 1 diabetes. There are a lot of unknowns about what triggers the autoimmune reaction that attacks the pancreas and destroys insulin-producing cells. However, researchers have not implicated any drugs in type 1 diabetes.
- Lithium and a handful of other drugs can cause diabetes insipidus, a rare form of diabetes marked by excessive urination and thirst. Although lithium is the most effective treatment for bipolar disorder, it can damage the kidneys and reduce their ability to properly regulate fluid balance, resulting in nephrogenic diabetes insipidus. Studies suggest that up to 40% of patients taking lithium develop symptoms of this disorder.
- Cancer drugs and antimicrobials used for severe infections have also been linked with reversible cases of nephrogenic diabetes insipidus.
The American Diabetes Association reports that 10.5% of Americans have diabetes, and more than twice that many have prediabetes, which increases the likelihood of developing full-blown disease. Therefore, it is more important than ever to be aware of all the factors—including prescription medications—that raise the risk of diabetes.
Of course, in some cases these medications are necessary, even lifesaving. However, there is widespread recognition that statins and antipsychotics in particular are used indiscriminately and inappropriately. If you are taking one of these two classes of drugs, talk to your doctor about this potential side effect and insist on close monitoring to catch and mitigate side effects early on before they lead to trouble.