The effect of the proton pump inhibitors on the glycemic control of the patients with type 2 diabetes mellitus

Background/Aim: Recently, some novel treatment options acting by increasing the functional ß cell mass and/or protecting the residue ß cells had been declared for the therapy of patients with type 2 diabetes mellitus other than drugs for glycemic control. One of these treatment alternatives is gastrin. It is known that, proton pump inhibitors which the diabetic patients frequently use decrease the amount of the gastric acid secretion and cause hypergastrinemia. For this reason, there had been interest whether these drugs effect the course of diabetes or not and limited number of studies were performed on this topic. However, it is important to predict the impact of the PPI derived hypergastrinemia on blood glucose levels and to find out new treatment modalities for this disease which have a growing incidence more and more.Patients and Methods: For this purpose, 43 patients being followed by our hospital with the diagnosis of type 2 DM, impared fasting glucose and/or impared glucose tolerance who were planned to take a proton pump inhibitor treatment because of dyspeptic symptoms were included in this study. The patients? serum insulin, C-peptide, hemoglobin A1c and gastrin levels and weights were defined before and after 12 weeks of treatment. It had been investigated whether there is statistical difference between the values before and after the treatment.Results: 36 (% 83.7) of the 43 patients attended for their control visits after the therapy. While the patients? pre and post treatment average gastrin levels were found significantly different (p<0.001), the other searched values did not have significant difference. None of the patients described hypoglycemia attacks during the treatment.Conclusion: Although the usage of the proton pump inhibitor induced hypergastrinemia for the treatment of diabetes is supported by a limited number of animal models and retrospective studies, prospective studies containing more patients and reliable results are needed.Key Words: ß cell reserve, Diabetes mellitus, Dyspepsia, Gastrin, Proton pump inhibitors