Current Status of Proton Pump Inhibitors in Pharmacotherapy of Diabetes Mellitus

Diabetes mellitus [DM] is a chronic metabolic disorder with its associated complications. Despite the plethora of available anti diabetic drugs to treat DM search continues to discover newer drugs. Proton pump inhibitors [PPIs] are the drugs which have been tested by researchers in animal models and in clinical set up to treat DM. They appeared to be promising drugs to reduce hyperglycemia. They can be used as supportive drugs along with the primary anti diabetic drugs. PPIs enhance rebound gastrin release, increase beta cell mass and insulin release. They are not hypoglycemic drugs. They reduce blood sugar by increase in gastrin and GLP-1 levels, decrease in ghrelin levels, reduced appetite, delayed gastric emptying and enhanced satiety through action on CNS.PPIs are the inhibitors of organic cation transporters (OCTs) for which metformin is the substrate and hence the plasma levels of metformin are increased. The potential and safety of PPIs in treatment of DM should be evaluated by long term clinical trials.