ABSTRACT
Drug-related illness is a major cause of morbidity and mortality in the United States; the annual cost is estimated to be close to $136 billion. The aging of the population, increasing use of multiple medications, and a general lack of understanding of drug interactions are some of the reasons for the increasing number of drug-related illnesses. Disorders of glucose metabolism are induced by many drugs, or preexisting diabetes mellitus can be worsened. During the initial evaluation of patients with diabetes mellitus, it is important to review the drug history and determine if the diabetes could be medication-related. The history should include a thorough assessment of all prescription drugs, over-the-counter medications, herbal preparations, and supplements that the individual is taking. Complicating a full understanding of this issue, few studies have comprehensively evaluated the frequency of drug effects on carbohydrate metabolism. Drug-induced diabetes holds no distinguishing clinical features from the naturally occurring disease, and the risk of diabetes mellitus from a particular drug in any individual is unpredictable. Thus, the practicing physician needs to be familiar with the drugs that affect glucose metabolism and hold a high index of suspicion, particularly in high-risk situations in which monitoring for diabetes becomes critical. This chapter provides an overview of the major drugs that impair glucose metabolism, either alone or in combination with other medications, and suggests ways for their recognition, treatment, and prevention Table 1 shows the drugs that are linked to precipitating and/or worsening hyperglycemia, and Table 2 shows those linked with hypoglycemia.
