Medications affecting glycemic control

Introduction: Review non-diabetes management medications that are commonly associated with either serious hyper-or hypoglycemia, or both, outline their mechanisms, and provide strategies for limiting these undesirable glycemic effects.Methods: Literature search of Pub-Med for studies in which drugs induced hyperglycemia or hypoglycemia.The primary outcome for this review was the incidence and occurrence of hyperglycemia and or hypoglycemia Results: Both hyperglycemia and hypoglycemia are associated with negative outcomes.Blood glucose variation was significantly associated with mortality in nondiabetic greater than diabetic patients.Medications may contribute to this glycemic variation manifested as either hyperglycemia or hypoglycemia.Many medications have been associated with aggravating hyperglycemia in diabetes mellitus patients, causing new hyperglycemia or outright diabetes in previously non-diabetic individuals.Steroids, immunosuppressive agents, antipsychotics and many other medications are commonly associated with hyperglycemia.On the other hand, hypoglycemia is an uncommon adverse effect associated with some antimicrobials and other medications.The risk may be increased, however, when such medications are used concomitantly with anti-diabetic agents.Benefits of these medications associated with hyper-or hypoglycemia may offset the potential adverse effects of abnormal glycemic control making overall management of the patient a challenge.Conclusion: Hyperglycemia, hypoglycemia, and glucose variation have been shown to contribute to negative outcomes.Therefore, it is imperative for clinicians to be aware of medications that may adversely affect glucose control.Withholding these medications may be justified in certain situations; however, any decision to avoid a medication based on glycemic effects must be carefully weighed against their benefit as well as the risks and benefits of alternative therapies.