Mechanisms of the diabetogenic effect induced by medications
Medical Review (Med. pregled), 2025, 61(4), 23-29.
M. Hristov1, Ts. Kirilov1, A. Nankova2, D. Vasileva1, P. Gateva1
1 Department of Pharmacology and Toxicology, Faculty of Medicine – Medical University of Sofia
2 Department of Endocrinology, Faculty of Medicine – Medical University of Sofia
Abstract. A number of widely used medications can affect glucose metabolism, leading to impaired glucose tolerance, hyperglycemia, or even newly diagnosed diabetes mellitus. The risk is higher in patients with genetic predisposition or preexisting metabolic disorders. Various mechanisms contribute to these effects, including reduced insulin sensitivity, increased hepatic glucose production, weight gain, impaired insulin secretion, and direct toxic effects on pancreatic β-cells. This review summarizes the key mechanisms by which certain pharmacological agents can induce hyperglycemia and diabetes mellitus. The drugs examined include beta-blockers, thiazide diuretics, statins, glucocorticosteroids, growth hormone, calcineurin inhibitors, antipsychotics, and protease inhibitors. Understanding these mechanisms is crucial for the early identification of risk and the implementation of an individualized therapeutic approach to minimize adverse metabolic consequences.
Key words: diabetes mellitus, beta-blockers, thiazide diuretics, calcineurin inhibitors, glu- cocorticosteroids, growth hormone, protease inhibitors, antipsychotics, statins
Address for correspondence: MIlen Hristov, e-mail: ; ; ORCID ID: 0000-0002-6185-2157