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Dose-Dependent Proton Pump Inhibitor Exposure and Risk of Type 2 Diabetes: A Nationwide Nested Case–Control Study

Author

Listed:
  • Hsin-Ya Kuo

    (Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan)

  • Chih-Sung Liang

    (Department of Psychiatry, Tri-Service General Hospital, Beitou Branch, National Defense Medical Center, Taipei 112, Taiwan)

  • Shih-Jen Tsai

    (Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan
    Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan)

  • Tzeng-Ji Chen

    (Department of Family Medicine, Taipei Veterans General Hospital, Taipei 112, Taiwan
    Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
    Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu 31064, Taiwan)

  • Che-Sheng Chu

    (Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
    Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung City 813, Taiwan
    Non-Invasive Neuromodulation Consortium for Mental Disorders, Society of Psychophysiology, Taipei 114, Taiwan
    Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung City 80708, Taiwan)

  • Mu-Hong Chen

    (Department of Psychiatry, Taipei Veterans General Hospital, Taipei 112, Taiwan
    Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan)

Abstract

Background: To investigate the association between proton pump inhibitor (PPI) exposure and a risk of type 2 diabetes mellitus (T2DM) among patients with upper gastrointestinal disease (UGID). Method: We conducted a case–control study from Taiwan’s National Health Insurance Research Database between 1998 and 2013. A total of 20,940 patients with T2DM and 20,940 controls were included. The dose of PPIs was categorized according to the cumulative defined daily dose (cDDD). The risk of T2DM was assessed using conditional logistic regression analysis. Result: Compared with cDDD ≤ 30, higher dosage of PPI exposure was associated with an increased risk of T2DM development: cDDD 31–120 (odds ratio [OR]: 1.20, 95% confidence interval [CI]: 1.13–1.26); cDDD 121–365 (OR: 1.26, 95% CI: 1.19–1.33); and cDDD > 365 (OR: 1.34, 95% CI: 1.23–1.46). Subgroup analysis of individual PPI showed that pantoprazole (OR: 1.14, 95% CI: 1.07–1.21), lansoprazole (OR: 1.08, 95% CI: 1.03–1.12), and omeprazole (OR: 1.11, 95% CI: 1.06–1.16) have a significantly higher risk of T2DM development. Conclusions: A dose-dependent increased risk of T2DM was found among patients with UGID using higher doses of PPIs compared with those with lower doses of these drugs. Further studies are necessary to investigate the underlying pathophysiology of PPIs and T2DM.

Suggested Citation

  • Hsin-Ya Kuo & Chih-Sung Liang & Shih-Jen Tsai & Tzeng-Ji Chen & Che-Sheng Chu & Mu-Hong Chen, 2022. "Dose-Dependent Proton Pump Inhibitor Exposure and Risk of Type 2 Diabetes: A Nationwide Nested Case–Control Study," IJERPH, MDPI, vol. 19(14), pages 1-9, July.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:14:p:8739-:d:865384
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    References listed on IDEAS

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    1. Grzegorz K. Jakubiak & Natalia Pawlas & Grzegorz Cieślar & Agata Stanek, 2021. "Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes," IJERPH, MDPI, vol. 18(22), pages 1-23, November.
    2. Chan Hyuk Park & Eun Hye Kim & Yun Ho Roh & Ha Yan Kim & Sang Kil Lee, 2014. "The Association between the Use of Proton Pump Inhibitors and the Risk of Hypomagnesemia: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-8, November.
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    1. Bin Xia & Qiangsheng He & Fang Gao Smith & V. Georgios Gkoutos & Krishnarajah Nirantharakumar & Zi Chong Kuo & Danni Wang & Qi Feng & Eddie C. Cheung & Lunzhi Dai & Junjie Huang & Yuanyuan Yu & Wenbo , 2024. "Individualized prevention of proton pump inhibitor related adverse events by risk stratification," Nature Communications, Nature, vol. 15(1), pages 1-12, December.

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