The findings, by joint first authors Jinqiu Yuan and Qiangsheng He with The Seventh Affiliated Hospital, Sun Yat-Sen University in Shenzhen, China, were published Tuesday in the journal Gut.
These commonly used medications called proton pump inhibitors (PPIs) work by “inhibiting certain stomach cells from ‘pumping’ acid into the stomach,” reports Harvard Medical School.
While PPIs are generally deemed safe for short-term use, prolonged use may introduce health concerns like bone fractures from calcium malabsorption and enteric (intestinal) infections, among other adverse effects.
PPIs were said to have a “major impact on gut microbiome,” which could increase the risk of type 2 diabetes, though the evidence is still unclear.
The risk was said to increase along with longer duration of use. Researchers found that the association was stronger among those with a lower Body Mass Index (BMI) or normal blood pressure.
“For patients who have to receive long-term PPI treatment, screening for abnormal blood glucose and type 2 diabetes is recommended,” study authors wrote.
The findings were drawn from an analysis of nearly 205,000 participants of three U.S. cohorts, Nurses’ Health Study (NHS), NHS II and Health Professionals Follow-up Study (HPFS), which revealed an increased risk even after adjusting for risk factors; “the absolute risk of diabetes among regular PPI users was 7.44/1000 person-years compared with 4.32/1000 person-years among non-users,” authors wrote.
“Owing to its wide usage, the overall number of diabetes cases associated with PPI use could be considerable,” authors concluded, adding that doctors should balance the risk-benefit ratio when prescribing PPIs for long-term use.