Medication Causes of Hyperglycemia

Aka: Medication Causes of Hyperglycemia, Medications Affecting Glucose Control, Medications Predisposing to Diabetes Mellitus

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II. Causes: Medications Predisposing to Diabetes Mellitus (with longterm use)

  1. Systemic Corticosteroids (e.g. Prednisone)
    1. Decreases Glucose uptake
  2. Thiazide Diuretics (e.g. Hydrochlorothiazide, Chlorthalidone)
    1. Inhibits Insulin release
    2. Hypokalemia mediated decreased Glucose control
    3. Risk of Diabetes Mellitus: 1 per 125 (for those using Thiazide Diuretic for at least 5 years)
      1. Risk increases to 1 in 17 if Impaired Glucose Tolerance is already present
  3. Statins (e.g. Atorvastatin, Simvastatin, Rosuvastatin)
    1. Decreases skeletal muscle Insulin sensitivity
    2. Risk of Diabetes Mellitus: 1 per 1000 (for those on Statin for 1 year)
  4. Atypical Antipsychotics (e.g. Clozapine, Zyprexa)
    1. Significant weight gain (via increased hunger)
  5. References
    1. (2014) Presc Lett 21(5): 28

III. Causes: Miscellaneous medications

  1. Azathioprine
  2. Chemotherapeutic medications
  3. Cimetidine (Tagamet)
  4. Morphine
  5. Methadone
  6. Anesthetics
  7. Tranquilizers

IV. Causes: Cardiovascular medications

  1. Potassium-wasting Diuretics (suppress Insulin secretion)
    1. Thiazide Diuretics (Hydrochlorothiazide, Chlorthalidone)
    2. Loop Diuretics (e.g. Furosemide or Lasix)
  2. Calcium Channel Blockers
  3. Epinephrine
  4. Propranolol
  5. Diazoxide (Hyperstat)

V. Causes: Neurologic medications

  1. Phenytoin (Dilantin, Suppresses Insulin secretion)

VI. Causes: Psychiatric medications (esp. Atypical Antipsychotics)

  1. Duloxetine (Cymbalta)
  2. Atypical Antipsychotics
    1. Clozapine (Clozaril) - higher risk
    2. Olanzapine (Zyprexa) - higher risk
    3. Risperidone (Risperdal)
    4. Quetiapine (Seroquel)
    5. Chlorpromazine (Thorazine)

VII. Causes: Endocrine medications

  1. Glucocorticoids or Corticosteroids (Antagonize Insulin action)
  2. Thyroxine
  3. ACTH

VIII. Causes: Infectious Disease medications

  1. Interferon
  2. Pentamidine
  3. Protease Inhibitors

IX. Causes: Recreational and Illicit Drugs

  1. Cocaine
  2. Alcohol

X. References

  1. Stoner (2017) Am Fam Physician 96(11):729-36 [PubMed]
  2. Stoner (2005) Am Fam Physician 71:1723-30 [PubMed]

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