Developing type 2 diabetes (T2D) is linked to taking more antibiotics in the years leading up to the diagnosis than people who do not have T2D, according to a study recently published in The Journal of Clinical Endocrinology & Metabolism.
Researchers led by Kristian Hallundbæk Mikkelsen, MD, of Gentofte Hospital in Hellerup, Denmark, and Anton Pottegaard, PhD, University of Southern Denmark, conducted a population-based case-control study, tracking antibiotic prescriptions for 170,504 people who had T2D and for 1.3 million people who did not have diabetes between January 1, 2000 and December 31, 2012. The team identified the subjects using records from the Danish National Registry of Patients, the Danish National Prescription Registry, and the Danish Person Registry.
People who had T2D filled 0.8 prescriptions a year, on average. The rate was only 0.5 prescriptions a year among the study’s control subjects. The researchers found that those who filled more prescriptions were more likely to be diagnosed with T2D. Many types of antibiotics were associated with a higher risk of diabetes, but there was a stronger link with the use of narrow-spectrum antibiotics such as penicillin V.
Past research has shown that antibiotic treatments can alter the bacteria in an individual’s gut. Studies suggest certain gut bacteria may contribute to the impaired ability to metabolize sugar seen in people with diabetes. This may explain why higher rates of antibiotic use are associated with the development of T2D, but more research is needed to explain the findings, Mikkelsen says.
The authors write that their results could support the possibility that antibiotics exposure increases type T2D risk. However, the findings may also represent an increased demand for antibiotics from increased risk of infections in patients with yet-undiagnosed diabetes. “In our research, we found people who have T2D used significantly more antibiotics up to 15 years prior to diagnosis compared to healthy controls,” Mikkelsen says. “Although we cannot infer causality from this study, the findings raise the possibility that antibiotics could raise the risk of T2D. Another equally compelling explanation may be that people develop T2D over the course of years and face a greater risk of infection during that time.”