Opioids and risk of type 2 diabetes in adults with non-cancer pain

Background: while the use of opioids for chronic non-cancer pain (cncp) has increased dramatically in the past 2 decades,concern exists about the safety of opioids,particularly with the extensive use among individuals with cncp. objective: to assess the risk of type 2 diabetes (t2d) among adults exposed to opioids for non-cancer pain. study design: nested case-control study. setting: united kingdom-based general practice research database (gprd). methods: among 1.7 million opioid users with at least one prescription for an opioid to treat non-cancer pain in the gprd (1990 - 2008),we identified all incident t2d cases with at least 2 years of medical history before their first diagnosis (index date). for each case we randomly selected up to 2 controls matched on age,gender,index date,and general practice. the same eligibility requirements were applied to controls as to cases. we defined any exposure as at least 2 prescriptions for an opioid within 2 years before the index date and defined nonuse as no use or only one prescription within 2 years (reference). for any exposure to opioids we further evaluated timing of use,cumulative use,and individual opioid type. conditional logistic regression was used to estimate adjusted odds ratios (aors) and 95% confidence intervals (cis) controlling for confounders. results: we identified 50,468 t2d cases to which we matched 100,415 controls. cases were more likely than controls to be former smokers,heavier,and to have more comorbidities,co-medications,and visits to their general practitioners. after adjusting for important confounders there was no increased risk for t2d among those exposed to any opioid compared to nonusers (aor = 1.03,95% ci 1.00 - 1.06). the results did not change when we evaluated timing of use,cumulative use,or individual opioid type. limitations: misclassification of exposure may have occurred; limited data for some individual opioid types. conclusion: this study found no association between use of opioids and risk of t2d among non-cancer adults.