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People’s Pharmacy: Drugs contribute to diabetes

Diabetes has become one of the world’s most troubling diseases. The American Diabetes Association estimates that nearly 28 million Americans have Type 2 diabetes. About 8 million have not been diagnosed, and another 86 million adults have prediabetes. The Centers for Disease Control and Prevention project that within the next three decades, 1 in 3 of us will develop this condition.

The consequences of this metabolic disorder are an increased risk for heart attacks, strokes, eye problems, kidney disease, amputations, dementia and death.

Why has diabetes become such a rapidly growing epidemic? The usual explanation unfairly blames the victims: They eat too much, they’re overweight, and they don’t exercise enough.

But what about factors that may not be under an individual’s control? For decades, people were told to reduce the amount of fat in their diet. That results in a diet lopsided in favor of carbohydrates. Sugar is frequently added to low-fat food to make it more palatable. High-fructose corn syrup is found in many beverages and processed foods. We now know that such a diet promotes weight gain, alters metabolism and predisposes people to Type 2 diabetes.

Chemicals in the environment also may contribute. There is a growing recognition that hormone-disrupting compounds used in many common household products can have a negative impact on health. Bisphenol A (BPA), phthalates and organic pollutants found in plastic bottles, metal cans, cosmetics, toys and pesticides are linked to insulin resistance (Diabetes and Metabolism online, Nov. 20, 2014). This is the first step in the development of Type 2 diabetes.

Prescription drugs pose an often-underrecognized risk for diabetes. Some of the most frequently prescribed medications in the world, including beta blockers and thiazide diuretics, can disrupt metabolism and cause Type 2 diabetes.

Corticosteroids such as prednisone are notorious for this complication. The longer a person takes a cortisone-type drug, the greater the risk. Even inhaled steroids used for chronic obstructive pulmonary disease, or COPD, may lead to disruption in blood sugar control (American Journal of Medicine, November 2010).

Perhaps the biggest shock to the medical community has been the revelation that statin-type cholesterol-lowering drugs such as atorvastatin (Lipitor), pitavastatin (Livalo), rosuvastatin (Crestor) and simvastatin (Zocor) also increase the likelihood of developing Type 2 diabetes or making blood sugar control more challenging. Although this connection has been known for several years, the increased risk was not considered significant by many cardiologists. Now, a six-year clinical trial of 8,749 Finnish men has determined that men taking a statin were 46 percent more likely to be diagnosed with diabetes during the study (Diabetologia online, March 4).

This connection is alarming because people with diabetes are now routinely prescribed statins to lower their risk of having a heart attack. The very drugs they are taking may make it harder to manage their condition.

It is becoming apparent that the causes of Type 2 diabetes are more complex than diet and exercise.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated program is on public radio. In their column, the Graedons answer letters from readers. Write to them at PeoplesPharmacy.com.