Drug-induced diabetes

Cases of drug-induced diabetes have also been reported (e.g., clozapine, olanzapine). 

Ferner RE. Drug-induced diabetes. Bailliere s Clin Endocrinol Metab 1992 6(4) 849-66. 

Nephrogenic diabetes insipidus has been described in patients receiving foscarnet, either alone or associated with a distal renal tubular acidosis [66, 67, 68]. In fact, a recent review cited foscarnet as the second most common reported cause of drug-induced diabetes insipidus, second only to lithium [69]. In experiments using toad urinary bladders [70], serosal application of foscarnet enhanced water flow in the presence of submaximal ADH concentrations, but did not affect water transport in the absence of ADH or when maximal concentrations of ADH were used. Mucosal foscarnet did not affect water transport. Further studies are needed to clarify the mechanisms for altered water handling by the kidneys with foscarnet. 

Bendz FI, Aurell M. Drug-induced diabetes insipidus incidence, prevention and management. Drug Saf 1999 2 449-456... 

Aminoguanidine has been shown to prevent the formation of AGEs (Brownlee et al., 1986) and treatment with this drug prevents retinal pericyte loss in STZ-induced diabetic rats (Hammes et al., 1990). More recendy, functional and structural impairments in peripheral nerves are ameliorated by aminoguanidine in male Wistar rats (Yagihashi et al., 1992). These data surest that inhibitors of non-enzymatic glycosyiation may have a future role in the treatment of diabetic complications. 

Henderson, D. C. (2002). Atypical antipsychotic-induced diabetes mellitus how strong is the evidence CNS Drugs, 16, 77-89. 

Only a few drugs have been identified as being capable of inducing autoimmune phenomena in mice. Among these are D-penicillamine, quinidine, streptozotocin (an anti-neoplastic drug that is also used as a model compound to induce diabetes) and procainamide. 

Others Acetazolamide Lithium Thiaazides Phenytoin Rash, fever, autoimmunity Dermatitis autoimmune thyroiditis, vasculitis Hypersensitivity, photosensitivity autoimmunity (diabetes) Rash drug-induced SLE, hepatitis... 

We call attention also to the web site for the Drug-Induced Liver Injury Network (DILIN) sponsored since 2003 by the National Institutes of Health (NIH), Liver Disease Branch of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). 

Fangchinoline (40), a 4> 5-benzylisoquinoline alkaloid isolated from Stephania tetrandra S. Moore (family Menispermaceae), was evaluated to possess significant antihyperglycemic activity studied in streptozotocin (STZ)-induced diabetic ddY mice in a dose-dependent manner the drug reduced the blood glucose level of diabetic mice by 52.7 6.7% when administered in 14 h-fasted diabetic mice at a dose of 1 mg/kg. Blood... 

Peripheral neuropathy (degeneration of peripheral sensory and/or motor neurons) represents another target for neurotrophic intervention. It often occurs as a complication of diabetes or in cancer patients receiving chemotherapy. In severe cases, amputation of limbs affected by neuronal loss is warranted. Pre-clinical studies have clearly shown that sensory and sympathetic neurons depleted in peripheral neuropathy respond to NGF. Indeed, NGF, along with IGF-1, can prevent the occurrence of drug-induced peripheral neuropathy in animals. Human clinical trials continue. 

Both drugs are used in conjunction with other diuretics like thiazide or loop diuretics to augment natriuresis and reduce loss of potassium. Triamterene may be used in the treatment of congestive heart failure, cirrhosis and the edema caused by secondary hyperaldosteronism. Amiloride is also useful in lithium induced diabetes insipidus. 

Glucocorticoids increase chromium losses and glucocorticoid-induced diabetes can be reversed by chromium supplementation (133). Doses of hypoglycemic drugs were also reduced by 50% in all patients when they were given supplementary chromium. 

Ben-Ami H, Nagachandran P, Mendelson A, Edoute Y. Drug-induced hypoglycemic coma in 102 diabetic patients. Arch Intern Med 1999 159(3) 281-4. 

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