Serving To Educate Primary Care Clinicians On Metabolic Issues
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News: Prescriber's Letter May 2014

Which meds can actually increase the risk of developing diabetes?
   We know that many drugs can cause hyperglycemia...but only some increase diabetes risk. Watch for chronic use of the bigger culprits...especially in a patient already at risk for diabetes.
   Oral and injectable corticosteroids decrease glucose uptake...and chronic use is a common cause of diabetes. Use the lowest effective dose.
   Topical or inhaled corticosteroids are less likely to cause hyperglycemia than the orals...but watch for patients using high doses.
   Thiazide diuretics can inhibit insulin release...and hypokalemia from the diuretic can also worsen glycemic control.
   About one more patient will get diabetes for every 125 using a thiazide for 5 years. Monitor patients more closely if they also have impaired glucose tolerance...the risk is one more case per 17.
   Statins can slightly increase diabetes risk...probably by reducing insulin sensitivity in skeletal muscle. 

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