When therapeutic drugs lead to diabetes

Diabetologia. 2022 May;65(5):751-762. doi: 10.1007/s00125-022-05666-w. Epub 2022 Mar 4.

Abstract

Drug-induced diabetes mellitus is a growing problem in clinical practice. New, potent medications contribute to this problem in a population already at high risk of developing glucose disturbances because of poor lifestyle habits and high prevalence of being overweight/obese. The present review focuses on four important pharmacological classes: glucocorticoids; antipsychotics, especially second generation; antiretroviral therapies, which revolutionised the management of individuals with HIV; and immune checkpoint inhibitors, recently used for the immunotherapy of cancer. For each class, the prevalence of drug-induced diabetes will be evaluated, the most common clinical presentations will be described, the underlying mechanisms leading to hyperglycaemia will be briefly analysed, and some recommendations for appropriate monitoring and management will be proposed.

Keywords: Antipsychotics; Antiretroviral therapy; Drug-induced diabetes; Glucocorticoids; Immune checkpoint inhibitors; Review; Secondary diabetes.

Publication types

  • Review

MeSH terms

  • Antipsychotic Agents* / adverse effects
  • Diabetes Mellitus* / drug therapy
  • Diabetes Mellitus* / epidemiology
  • Humans
  • Hyperglycemia* / drug therapy
  • Immunotherapy

Substances

  • Antipsychotic Agents