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Repeated Use of Antibiotics Linked to Diabetes Risk

Findings emphasize need to reduce unnecessary prescriptions

Repeated use of some types of antibiotics may put people at increased risk of developing type-2 diabetes by possibly altering their gut bacteria, according to a large observational study published online March 24 in the European Journal of Endocrinology. The findings emphasize the need to reduce unnecessary antibiotic prescriptions, the authors say.

Researchers at the University of Pennsylvania looked at the number of antibiotic prescriptions given out in the United Kingdom to more than 200,000 diabetics at least 1 year before they were diagnosed with the disease, and compared this with the number given to 800,000 non-diabetic patients of the same age and sex.

They found that patients prescribed at least two courses of penicillins, cephalosporines, quinolones, and macrolides were at higher risk of being diagnosed with type-2 diabetes. The risk increased with the number of antibiotic courses prescribed.

Patients prescribed two to five courses of penicillins increased their risk of diabetes by 8%, whereas the risk increased by 23% among those with more than five penicillin courses. For quinolones, the diabetes risk increased by 15% among patients who received two to five courses and by 37% among those with more than five courses. The risk was calculated after adjusting for other risk factors, such as obesity, smoking history, heart disease, and history of infections.

“Gut bacteria have been suggested to influence the mechanisms behind obesity, insulin resistance, and diabetes in both animal and human models,” said lead author Dr. Ben Boursi. “Previous studies have shown that antibiotics can alter the digestive ecosystem.”

Senior author Dr. Yu-Xiao Yang commented: “While our study does not show cause and effect, we think changing levels and diversity of gut bacteria could explain the link between antibiotics and diabetes risk.”

An increased diabetes risk was not observed in patients receiving antiviral or antifungal medications, and the study found little evidence of a link between antibiotic use and the risk of type-1 diabetes.

“Overprescription of antibiotics is already a problem around the world as bacteria become increasingly resistant to their effects” Boursi said. “Our findings are important, not only for understanding how diabetes may develop, but as a warning to reduce unnecessary antibiotic treatments that might do more harm than good.”

Sources: Medical Xpress; March 25, 2015; and European Journal of Endocrinology; March 24, 2015.


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