Proton pump inhibitor therapy associated with lower glycosylated hemoglobin levels in type 2 diabetes

Introduction: oral hypoglycemic medications sometimes do not control type 2 diabetes well. proton pump inhibitors (ppis) as adjunctive therapy might improve diabetes control through increasing serum gastrin and fasting insulin levels. methods: electronic medical records in a family medicine residency program office practice were reviewed for 73 individuals with type 2 diabetes (not taking insulin),for whom ppis were prescribed. values for glycosylated hemoglobin (hba1c) for periods of time when a ppi had been prescribed were compared with hba1c levels for periods of time with no record of ppi prescribing or over-the-counter ppi use. results: the mean hba1c for patients not taking insulin was 7.11 during periods with recorded prescribing or over-the-counter use of ppis,compared with 7.70 during periods without recorded ppi therapy (p ∇ .001). mean hba1c for metformin monotherapy was not significantly different (6.81 with ppi vs. 7.10 without ppi; n = 16; p = .25). mean hba1c was significantly different for combination therapy that included metformin and/or sulfonylurea and/or giltazone (7.26 vs. 7.80; n ∇ 27; p ∇ .002). conclusion: the observed association between ppi therapy and lower hba1c levels suggests that ppis may be useful as adjunctive therapy for type 2 diabetes.