oa SA Pharmaceutical Journal - Diabetogenic drugs : treating chronic conditions to minimise new onset diabetes : review

Volume 77, Issue 10
  • ISSN : 2221-5875
  • E-ISSN: 2220-1017



Patients at high risk for developing type 2 diabetes mellitus often need treatment for one or more chronic conditions. Since conditions such as obesity, hypertension, schizophrenia and depression may increase the risk for diabetes, all additional risk factors need to be minimised. Lifestyle management remains the first step in this process. Control of the chronic condition is the first priority using the least diabetogenic drug or combination as far as possible. Guidelines for treating hypertension in high risk patients are to use a diuretic in combination with either an angiotensin-converting enzyme inhibitor (ACE inhibitor) or an angiotensin II receptor blocker (ARB). Fluoxetine, citalopram and sertralin have not shown an increase in new onset diabetes when used to treat depression. The least diabetogenic drugs to treat psychosis seem to be aripiprazole or ziprasodone. Continuous monitoring, switching when possible to lower risk drugs or sometimes treatment may be necessary to prevent or manage diabetes in these patients.

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