Antacids help control blood sugar in people with diabetes


July 2, 2021 — A new analysis shows that a class of drugs widely used to treat heartburn and stomach ulcers improves blood sugar control in people with diabetes when added to standard treatment.

But the same class of drugs — known medically as proton pump inhibitors (PPIs) and include agents like omeprazole — did not prevent diabetes in people who don’t already have it, the same research has shown.

In addition to acting on acid suppression, “we know that these drugs affect certain gut hormones that are important in glucose regulation,” Dr. Kashif Mounir told WebMD.

“So if someone is already using proton pump inhibitors and is doing well, this provides them with some recognition that proton pump inhibitors may also be helpful for diabetes if they have it,” he said.

The study was published online on June 25, 2021, at Journal of Endocrinology and Metabolism.

Antacids lowered two measures of diabetes

Munir, MD, associate professor of endocrinology, diabetes and nutrition at the University of Maryland School of Medicine in Baltimore, and colleagues examined the results of five studies involving nearly 250,000 people without diabetes. The researchers did not find that the use of proton pump inhibitors reduces the risk of developing new diabetes in this population.

But then they looked at seven studies involving 342 patients with diabetes to see what effect PPIs had on blood sugar control.

“Overall, PPI therapy as an add-on to standard care was associated with an additional 0.36% decrease in glycosylated hemoglobin (HbA1c) compared to standard therapy,” they report.

Glycosylated hemoglobin is a measure of a patient’s average blood sugar levels over the past two to three months, and levels of 6.5% or higher on two separate tests to diagnose diabetes.

Mounir noted that while a 0.36% reduction in A1c may seem modest, the Food and Drug Administration is considering glucose-lowering drugs for approval if they lower A1c by less than 0.3%.

Similarly, use of proton pump inhibitors over standard antidiabetic therapy was associated with an additional, albeit again modest, decrease of 10.0 milligrams per deciliter (mg/dL) in fasting blood sugar.

The researchers found that the higher the PPI dose, the better the glycemic-lowering effect, too.

And patients with poor blood sugar control — reflected in elevated A1c — benefited more when they took antacids than those whose diabetes was well controlled initially.

The researchers concluded that the effect of proton pump inhibitor antacids on glycemic control “should be taken into account when prescribing antacids to patients with diabetes.”

“If you are someone [with diabetes] For those who suffer from heartburn, proton pump inhibitors may be considered a potentially beneficial treatment for treating both conditions with one medication.

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Kashif Mounir, MD, assistant professor of endocrinology, diabetes, and nutrition, University of Maryland School of Medicine, Baltimore.

Journal of Endocrinology and Metabolism: “Effects of proton pump inhibitors on glycemic control and incident diabetes: a systematic review and meta-analysis.”

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