Diabetes affects about one tenth of the American population and is the seventh leading cause of death in the United States. As prevalent as diabetes is in the United States is the high exposure to antibiotics. A new study, published in Primary Care Diabetes, by Dr. Farrokh Alemi, CHHS professor of health administration and policy, Dr. Sanja Avramovic, assistant professor and colleagues found that repeated exposure to commonly used antibiotics increased the risk of diabetes by 13%.
Alemi, Avramovic and their colleague Mark Schwartz at New York University, used medical data from Veterans Affairs Informatics and Computer Infrastructure Workplace to compare a group of veterans that share a common exposure to antibiotics to another group of veterans not exposed to examine antibiotics’ influence on diabetes.
“Results from this study add to the growing evidence supporting the possibility that antibiotics exposure increases risk for type 2 diabetes,” Alemi said. “Better understanding this risk can help enhance our antibiotics stewardship and may lower the incidence of diabetes in populations at risk.”
Data from 14,361 veterans at the New York Harbor Healthcare System enrolled in primary care from 2004 through 2014 were collected for the researchers to analyze the correlation between risk factors and type 2 diabetes. The majority of the study population was white (54.7%), male (94.9%), and greater than 55 years of age (65.3%). 9,922 (69.11%) veterans were prescribed antibiotics during the study period.
“While the study has strengths such as a large cohort and a robust electrical medical record, its true contribution is that it uses analytic strategies which are much more specific than the straightforward approach of simply checking for antibiotic exposure: the study checks for Mean Daily Dose and the cumulative exposure over days, in order to account for time-varying and quantity-varying risks,” Avramovic said.
The researchers also found that the influence of antibiotics differs among different types of these medications. More specifically, using antibiotics such as antifungal, macrolide, penicillin and quinolone increases the risk for type 2 diabetes, while two types of antibiotics (aminoglycosides and antivirals) do not increase risk.
They pointed out that antibiotics not only kill harmful bacteria, but can also affect beneficial bacteria, causing changes in gut bacterial populations that are associated with type 2 diabetes.
“Antibiotics are thought to affect diabetes by disturbing gut bacteria, which causes subsequent effects on inflammation,” Alemi noted. “Future studies should investigate how different combinations of antibiotics intake affects changes in human gut bacteria in the long-term.”