Corticosteroids and Other Medications Can Increase Your Diabetes Risk


Some antipsychotic drugs may also raise your diabetes risk.(ISTOCKPHOTO/HEALTH)A variety of prescription medications have been linked to a higher risk of type 2 diabetes.

These include blood-pressure drugs called thiazide diuretics and beta-blockers; glucocorticoids, which are anti-inflammatory drugs; and some antipsychotics, which are used to treat a variety of serious mental illnesses. It is unclear whether certain drugs actually cause diabetes or speed up a diagnosis in someone prone to the disease; the cause may vary depending on the type of drug.

If you're concerned about diabetes, ask your doctor whether any medications you're taking may affect your risk.

A 2007 review of 22 clinical trials including more than 143,000 people found that different blood-pressure drugs carry different diabetes risks. Beta-blockers and diuretics are most often associated with diabetes, and angiotensin-receptor blockers (ARBs) and angiotensin-converting-enzyme (ACE) inhibitors are least associated with it.

Blood-pressure medication
If you have high blood pressure, the risk it poses to your health is more of an immediate concern than your risk of developing diabetes, says William Elliott, MD, of Rush University Medical Center in Chicago and the study's author.

"There are some differences across different medicines in the person's chances of getting diabetes, but it's much more important to have controlled blood pressure than worry about whether the medications will make you diabetic or not. Don't increase your blood pressure by worrying about this too much," he says.

Still, talk to your doctor about other ways to reduce your diabetes risk (such as losing weight, if necessary) if you're taking a blood-pressure drug.

Antipsychotic drugs
Some antipsychotic drugs used to treat schizophrenia, the manic symptoms of bipolar disorder, and a growing list of other conditions may also raise your risk of diabetes, says John W. Newcomer, MD, a professor of psychiatry, psychology, and medicine at Washington University School of Medicine in St. Louis.

In most cases, this risk comes from the weight gain and increased body fat that can result from taking the drug. He's concerned about this link, since a great deal of research has shown that people with major mental disorders tend to have a life expectancy that's shortened by 25 to 30 years, often due to premature heart disease (diabetes can raise the risk of heart attack and stroke).

If you need an antipsychotic drug, you should sit down and talk with your doctor, and "if at all possible start on an agent at the low end of the risk spectrum," he says. "If you can get a good clinical response and keep the risk low, it's a win-win."

Antipsychotic drugs that are associated with a relatively low diabetes risk include the older drug haloperidol (Haldol), and the newer drugs ziprasidone (Geodon) and aripiprazole (Abilify).