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

(6) thiazides

(7) diazoxide (related to the thiazides)

(8) dilantin/phenytoin

(9) interferon-alpha

(10) atypical antipsychotics

(11) cyclosporine or tacrolimus

(12) didanosine

(13) protease inhibitors

(14) L-asparaginase

(15) terbutaline

(16) ritodrine

(17) calcium-channel blockers

(18) minoxidil

(19) tesamorelin


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)

(2) Vacor

(3) streptozotocin (an alkylating agent)

(4) alloxan



• Vacor (Rohm & Haas) is the brand name for pyriminil, which is used as a rodenticide.

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