Proton pump inhibitors may improve HbA1c in Type 2 diabetics
MedWire News: Treatment with the proton pump inhibitor (PPI) esomeprazole improves glycated hemoglobin (HbA1c) levels in patients with Type 2 diabetes, suggest results from a small retrospective analysis.
"If the secretion of gastric acid is inhibited by for instance PPIs, plasma gastrin levels will increase due to the lack of feedback inhibition," explain Kristine Færch (Steno Diabetes Center, Gentofte, Denmark) and co-workers. "This could potentially affect beta cell mass and function and thereby improve glycemic control."
Prompted by previous positive results in diabetic animals treated with PPIs, Færch and team measured HbA1c levels in 21 patients with Type 2 diabetes who had been treated with the PPI esomeprazole for 11 months and those of 21 diabetic controls not treated with esomeprazole. HbA1c levels were compared with those measured 11 months previously.
HbA1c decreased from a mean of 8.6% at baseline to 7.9% at 11 months in the esomeprazole group, a significant difference, and from 9.2% to 9.0% in the control group, a nonsignificant difference.
The researchers concede that the small and retrospective nature of the study means that the results should be treated with caution.
They say: "It is possible that the effects of esomeprazole on glycemic control in the studied patients is related to relief of gastro-intestinal (or other) symptoms due to esomeprazole treatment that indirectly affect glycemic control rather than being a direct effect of esomeprazole on gastrin levels and consequently proliferation of beta cells."
However, they conclude that PPI treatment seems to hold promise for helping to reduce HbA1c in patients with Type 2 diabetes. They add that "randomized, placebo-controlled studies are needed to determine the potential for PPI's to become a new class of anti-diabetic agents."
The results of this study are published in the journal Diabetes Research and Clinical Practice.
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By Helen Albert