- A new study found that certain antacids may improve blood sugar levels in people with diabetes.
- Antacids called proton pump inhibitors (PPIs) appear to be safe in people with diabetes.
- However, earlier research found that long-term use of PPIs may be associated with health issues, including nutrient deficiencies, cognitive decline, and an increased risk of kidney disease.
A study published this month in the Journal of Clinical Endocrinology & Metabolism found that certain over-the-counter (OTC) proton pump inhibitors (PPIs), a type of antacid, may improve blood sugar levels in people with diabetes.
The meta-analysis reviewed 12 studies on glycemic control and diabetes and found that PPIs, taken as an add-on to standard treatment, appeared more effective at lowering glucose levels than standard therapy alone.
PPIs appeared to be safe in people with diabetes, but preexisting research suggests that long-term use of PPIs may be associated with nutrient deficiencies, cognitive decline, and an increased risk of kidney disease.
Health experts agree that more research is needed to better understand if and how PPIs could be used to improve blood sugar levels.
“Unless the patient has a gastrointestinal indication to be on antacids, I would not recommend starting antacids purely with the hope that it will help diabetes,” said Dr. Marilyn Tan, an endocrinologist with Stanford Health Care in Palo Alto, California.
If a patient with diabetes needs PPIs for gastrointestinal issues, “the patient and the physician should feel comfortable starting the PPI without worrying that it will significantly worsen diabetes,” Tan said.
Certain antacids seem to safely lower blood glucose levels
To determine the effect of OTC PPIs on blood glucose levels in people with diabetes, the researchers evaluated seven studies on glycemic control and five studies on the risk of diabetes.
They found that PPIs could reduce hemoglobin A1c (HbA1c) levels by about 0.36 percent and lower fasting blood sugar by 10 mg/dl in people with diabetes.
PPIs, given in conjunction with standard therapy, led to more significant declines than standard therapy alone.
PPIs did not lower the risk of diabetes in people without the disease.
Given the findings, the researchers suggest PPIs should be considered as an add-on treatment to help diabetes patients improve glycemic control.
“The proposed mechanism is that PPIs elevated gastrin levels, and gastrin may improve insulin resistance and insulin response, thus helping to lower blood glucose. However, further studies in humans are needed in order to draw such a conclusion,” explained Tan.
Patients involved in clinical trials often have better glycemic control since they are visiting the doctor more frequently and being held accountable, Tan says.
What experts think about taking PPIs for glucose control
Though the study suggests that PPIs are safe in patients with diabetes, health experts do not recommend people with diabetes begin taking the OTC medications to improve their blood sugar levels.
“PPIs are not FDA approved for blood sugar control and have not been studied in clinical trials for blood sugar lowering,” Tan said.
The findings are encouraging but association is not causation, Tan added.
According to Tan, there are many limitations to meta-analysis studies such as this one, and randomized controlled trials are needed to examine the direct impact of PPIs on glucose levels in people with diabetes.
“Effects are often multivariate, the quality of the studies included is not guaranteed, and there can be many biases,” Tan said of meta-analysis reviews.
PPIs may have side effects over time
Tina Marinaccio, a registered dietitian nutritionist with Health Dynamics LLC in Morristown, New Jersey, says PPIs should never be used as a first-line treatment for diabetes.
There are risks to taking PPIs, previous research suggests.
“Stomach acid is there for a reason. Suppressing it changes the pH of the stomach and therefore increases risk for foodborne illness,” Marinaccio told Healthline.
PPIs may also decrease absorption of essential nutrients, including vitamin B12, vitamin C, calcium, iron, and magnesium. This may lead to deficiencies in some people, according to Marinaccio.
Other research has previously linked PPIs to cognitive decline and an increased risk of kidney disease.
Until we have more data, lifestyle changes and standard treatment are the recommended approach to helping patients with diabetes manage their blood sugar levels.
“For type 2 diabetes, see a registered dietitian to exhaust lifestyle change strategies such as diet, exercise, and stress management before using medicines,” Marinaccio said.
The bottom line:
A new meta-analysis suggests proton pump inhibitors (PPIs) — a type of over-the-counter antacid — may improve blood sugar levels in people with diabetes. PPIs appeared to be safe in people with diabetes, but preexisting research suggests that long-term use of PPIs may be associated with side effects, including nutrient deficiencies and cognitive decline. More research is needed to understand better how PPIs could be used for blood sugar control — until then, health experts recommend patients with diabetes continue standard therapy in conjunction with lifestyle changes to improve their glucose levels.
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