September 28, 2020

expert reaction to observational study of PPIs and type-2 diabetes

Research, published in Gut, looked at proton pump inhibitors (PPIs) and type-2 diabetes.

Prof Naveed Sattar, Professor of Metabolic Medicine, University of Glasgow, said:

“This new research is somewhat interesting, but its only observational: that means it can’t establish cause and effect.  I am simply not convinced that PPI use actually increases diabetes risk. There could be a number of other reasons, what we call ‘residual confounding’ – for example, people who take PPIs may also be more likely to have unhealthy lifestyles in other ways, and the authors have not fully adjusted for all the other things that could cause diabetes and lead people to take more PPI. 

“The models also appear not to take into account social class and do not always use continuous measures for some other important confounders, thereby potentially under-adjusting for differences between people who do or do not take PPIs.  A previous study of randomised controlled trials of PPI did not see any clear evidence of adverse effect of this class on glucose or insulin levels in people with diabetes.  I would therefore be strongly sceptical of jumping to conclusions based on this research.”

‘Regular use of proton pump inhibitors and risk of type 2 diabetes: results from three prospective cohort studies’ by Jinqiu Yuan et al. was published in Gut at 23.30 hours UK time Monday 28 September 2020.

doi:10.1136/gutjnl-2020-322557

Declared interests

None received.