A numbers of drugs and chemicals may cause hyperglycemia by interfering with insulin secretion or peripheral action. These agents can result in overt diabetes in a person with insulin resistance.
(1) hyperglycemia following onset of therapy with drug or exposure to chemical
(2) diabetes may develop if the exposed patient has insulin resistance and/or features of the metabolic syndrome
(3) reversal on discontinuation of exposure (if reversible agent)
Drugs with reversible effect include:
(1) nicotinic acid
(2) glucocorticoids or anabolic steroids in high doses
(3) thyroid hormone
(4) alpha-adrenergic agonists or centrally-acting alpha blockers
(5) beta-adrenergic agonists or beta-blockers
(7) diazoxide (related to the thiazides)
(10) atypical antipsychotics
(11) cyclosporine or tacrolimus
(13) protease inhibitors
(17) calcium-channel blockers
Drugs and chemicals with potentially irreversible effect (due to destruction of pancreatic beta cells):
(1) pentamidine (also may cause severe hypoglycemia for weeks after therapy, perhaps due to release of insulin from injured beta cells)
(3) streptozotocin (an alkylating agent)
• Vacor (Rohm & Haas) is the brand name for pyriminil, which is used as a rodenticide.
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Purpose: To evaluate a patient for drug or chemical induced hyperglycemia and diabetes.
Specialty: Endocrinology, Clinical Laboratory
Objective: risk factors, clinical diagnosis, including family history for genetics