Effect of Proton Pump Inhibitor Administration onGlycemicParametersinPatientswithType2DiabetesMel-litus

ntroduction: Proton pump inhibitors can influence glucose-insulin homeostasis by elevating plasma gastrin.Considering the few clinical trials and contradictory results of previous studies, we aimed to evaluate the effect ofomeprazole, a proton pump inhibitor, on glucose-insulin homeostasis in patients with type 2 diabetes mellitus(T2DM).

In this before-after clinical trial, 40 patients with T2DM received omeprazoletreatment for 12 weeks. Patients were asked to continue their diet, lifestyle, and physical activity throughoutthe study period. Glycosylated hemoglobin (HbA1c), fasting plasma sugar (FBS), insulin level, C-peptide and 2hours post prandial blood sugar (2hppBS) were measured at baseline and after 12 weeks. Homeostatic modelassessment of Insulin resistance (HOMA-IR) and homeostatic model assessment ofβ-cell dysfunction (HOMA-B) indices were also calculated at baseline and after 12 weeks of omeprazole administration.

After 12weeks of omeprazole administration, there was a clear decrease in the mean HbA1C before (8.11±0.96) and after(7.13±0.68) the treatment (P<0.001). Similarly, a decrease in mean FBS and 2HPPBS before and after treatmentwas observed, which was statistically significant for FBS (P=0.01) but not for 2HPPBS (P=0.1). There was a clearincrease in the level of Insulin (P=0.001) and C-peptide (P=0.003). The mean activity index of HOMA-B beforeand after receiving omeprazole was 54.41±27.06 and 79.24±45.32, respectively (P=0.007). Also, HOMA-IR indexwas 5 before, and 6 after receiving omeprazole (P=0.001).

Administration of omeprazole, increasesinsulin levels and decreases the levels of HbA1c, FBS, thus improving glycemic status and can be combined withother drugs used to manage DM, especially in patients with gastrointestinal problems; but more studies areneeded.