The Upset Truth: Trusted Antibiotics Fall Short of Expectations
Upcoming findings from the European Association for the Study of Diabetes (EASD) in Hamburg, Germany highlight a significant concern for diabetics taking specific medications.
The study reveals that diabetics on certain antibiotics, antipsychotics, and prokinetics (medications addressing nausea and vomiting) face an increased chance of a severe cardiac event. The concern lies with these drugs altering the heart’s electrical rhythm, specifically causing QT-prolongation.
Key Drugs Causing QTc-Prolongation:
- Prokinetics: Domperidone
- Antibiotics: Macrolides, Fluoroquinolones
- Antipsychotics: Haloperidol
Diabetes UK’s recent statistics show a staggering 4.3 million people diagnosed with type 2 diabetes in the UK. This number heightens the concern, as those on QTc-prolonging antibiotics, for instance, may be more susceptible to life-threatening cardiac events.
Cardiac arrest, a primary mortality cause, is when the heart ceases to circulate blood. Peter Harms from Amsterdam UMC notes that type 2 diabetics inherently have double the risk of experiencing a sudden cardiac arrest.
Harms, alongside his team, evaluated GP records to understand the clinical traits tied to sudden cardiac arrests in type 2 diabetics, considering patients with and without prior cardiovascular issues. This ten-year study (2010-2019) in Noord-Holland involved 3,919 type 2 diabetics, with 689 experiencing sudden cardiac arrests.
Upon assessing clinical data like medication records, blood readings, and historical health information from five years preceding a cardiac arrest, the team identified several associated risk factors:
- History of arrhythmias (68% elevated risk)
- Uncertain smoking habits (40% elevated risk)
- Insulin administration (138% risk increase)
- Use of QTc-prolonging prokinetic drugs (66% elevated risk).
Moreover, diabetics without prior cardiovascular issues but with lower fasting glucose levels, indicative of overly strict blood sugar control, faced a 150% increased cardiac arrest risk. Additional identified risks were severe hypertension, unsatisfactory blood lipid levels, and QTc-prolonging drugs.
Concluding the findings, Harms emphasized the importance for general practitioners to recognize the potential dangers of excessively tight glycaemic control and the prescription of these widespread medications.
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