Dean Pomerleau Posted December 4, 2015 Report Share Posted December 4, 2015 Antibiotic Use Linked to Higher Diabetes Risk Note: I'm starting a new generic thread about diabetes prevention with a rather narrowly focused post about diabetes and antibiotics, because I thought the study was interesting and suggested a link I hadn't heard about before. Over time I hope we'll build up posts on this thread dealing with other means of avoiding this important cause of morbidity and mortality. With that background, I thought this recent observational study  of a possible link between antibiotic use and subsequent development of type 2 diabetes was quite interesting and potentially relevant for CR Practitioners. It found quite a clear and dramatic dose-response relationship between the number of antibiotic prescriptions a person fills, and their subsequent risk of developing type 2 diabetes, among 5.6 million Danish people tracked for 12 years. Here is the kicker graph from the full text of the paper: As you can see from the graph, 2-4 courses of an antibiotic raised one's risk of developing diabetes by about 20%, and 5-8 courses raised it by about 40%. The authors suggest (warn) that there are two possible ways to interpret this association: There are two competing interpretations of our findings: 1) patients with type 2 diabetes are more prone to develop infections many years before they become diagnosed with type 2 diabetes and therefore have increased demand for antibiotics and 2) antibiotics increase the risk of type 2 diabetes. They suggest it may be a combination of both, but that there is definitely evidence that messing up one's gut microbiome via antibiotics can lead to weight gain, glucose intolerance, etc. So a causal link that goes as follows: antibiotics -> gut dysbiosis -> metabolic syndrome -> Type 2 diabetes seems quite plausible. I'm personally thankful that I haven't needed antibiotics in many, many years, and would be reluctant to take them now unless there was a significant danger of serious health consequences from not doing so. --Dean ----------  J Clin Endocrinol Metab. 2015 Oct;100(10):3633-40. doi: 10.1210/jc.2015-2696. Epub 2015 Aug 27.Use of Antibiotics and Risk of Type 2 Diabetes: A Population-Based Case-ControlStudy.Mikkelsen KH(1), Knop FK(1), Frost M(1), Hallas J(1), Pottegård A(1).CONTEXT AND OBJECTIVE: Evidence that bacteria in the human gut may influencenutrient metabolism is accumulating. We investigated whether use of antibioticsinfluences the risk of developing type 2 diabetes and whether the effect can beattributed to specific types of antibiotics.METHODS: We conducted a population-based case-control study of incident type 2diabetes cases in Denmark (population 5.6 million) between January 1, 2000, andDecember 31, 2012. Data from the Danish National Registry of Patients, the DanishNational Prescription Registry, and the Danish Person Registry were combined.RESULTS: The odds ratio (OR) associating type 2 diabetes with exposure toantibiotics of any type was 1.53 (95% confidence interval 1.50-1.55) withredemption of more than or equal to 5 versus 0-1 prescriptions. Although noindividual group of antibiotics was specifically associated with type 2 diabetesrisk, slightly higher ORs for type 2 diabetes were seen with narrow-spectrum andbactericidal antibiotics (OR 1.55 and 1.48) compared to broad-spectrum andbacteriostatic types of antibiotics (OR 1.31 and 1.39), respectively. A cleardose-response effect was seen with increasing cumulative load of antibiotics. Theincreased use of antibiotics in patients with type 2 diabetes was found up to 15years before diagnosis of type 2 diabetes as well as after the diagnosis.CONCLUSIONS: Our results could support the possibility that antibiotics exposureincreases type 2 diabetes risk. However, the findings may also represent anincreased demand for antibiotics from increased risk of infections in patientswith yet-undiagnosed diabetes.PMCID: PMC4596043PMID: 26312581 Link to comment Share on other sites More sharing options...
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