Think before you pop that pill

If your general physician writes you a prescription for antibiotics every time you’re ill, as if he/she were handing you a lolly, then it’s time you ask for an alternative. Though antibiotics help killing infections, they also have a number of harmful side-effects. While you might be familiar with antibiotic resistance, a new study has come into the spotlight that taking too many antibiotics can increase the risk of type 2 diabetes. Read on to know more...

The study
If you have been taking antibiotics on several occasions, then you have reason to worry. Experts have warned that taking too many antibiotics could raise the risk of developing type 2 diabetes. Too many? You heave a sigh a relief thinking that’s not you. However, as per the results of a large study, individuals who receive more than four courses of the drugs over 15 years are 53 per cent more likely to get the disease. 

Researchers said behind this study of 1.4 million Danish patients shows a clear link between antibiotics and diabetes. While antibiotics are designed to kill the bacteria that cause infections, in the bargain, they also destroy some of the good bacteria present in the gut, which are known to influence digestion and metabolism. And perhaps, this is the reason for the link between antibiotics and diabetes, with alterations in gut bacteria meaning people absorb sugar and fat in different ways. Also, an  alternative explanation could be that individuals with as-yet undiagnosed diabetes may be more prone to infection, and therefore use more antibiotics, the study authors said.

Study author Dr Kristian Mikkelsen, from Gentofte Hospital in Hellerup, Denmark, said: “In our research, we found people who have type 2 diabetes used significantly more antibiotics up to 15 years prior to diagnosis compared to healthy controls. Although we cannot infer causality from this study, the findings raise the possibility that antibiotics could raise the risk of type 2 diabetes.”

Expert speak
Dr Pradeep Gadge, consultant diabetologist and endocrinologist, Breach Candy Hospital and Seven Hills Hospital agrees that definitely there’s a link between the use of gut bacteria and diabetes and there are multiple studies done in Canada and UK that support this theory. There are studies which discuss that introducing some of these gut bacteria into system could alter the metabolism and that chances of diabetes could be lesser. 

But can’t the gut bacteria be replenished by consumption of probiotics ? He says, “Some of the good bacteria play some role in prevention of inflammation in the body. Once the good bacteria is killed, damage is done. Having probiotics cannot replace the gut bacteria which have destroyed due to antibiotics, which create a vast destruction. This idea of replenishing gut bacteria with probiotic products is milked by pharmaceuticals for their benefit.” As for side-effects of antibiotics, antibiotic resistance  is a growing issue. “In the last 20 years, few new group of antibiotics have been developed. There are no new antibiotics, which is also a concern for drug resistant infections like tuberculosis. Also, multidrug resistance is another danger,” adds Dr Gadge.

The study on antibiotics and diabetes is really an eye-opener for the world. There appears to be a link between excessive antibiotic use and blood glucose. This may have few implications as there is possibility of infections in diabetic patients. Also, change in the microorganism so the intestines may be altered due to antibiotic ingestion. While having an effect on the particular organism(s), it may also kill or reduce number of few other organism who have effect on our glucose metabolism, says Dr Altamash Shaikh, endocrinologist, Saifee Hospital.

Another possibility is that many people are unaware or not yet diagnosed with diabetes or may be just borderline diabetics and hence more prone to develop infections. Also, some people may have complications of diabetes even before it is diagnosed like neuropathy (altered sensation) or vasculopathy (involvement of blood vessels) which may give way to minute injuries and  consequent infections, says Dr Shaikh adding that “We need to wait for more data to evolve and understand still other unknown mechanisms by which antibiotics may cause diabetes.” 

“This is just one study that draws a correlation between taking antibiotics and diabetes. There needs to be more studies with conclusive evidence establishing a link between the two. Having said that, it’s a very interesting proposition which raises possibilities — whether killing of normal gut bacteria can raise the risk of type 2 diabetes,” opines Dr Behram Pardiwala, internal medicines consultant, Wockhardt Hospital. As for the harmful side-effects of antibiotics, he says there are many, like inappropriate prescription of antibiotics and their dosage, antibiotics associated diarrhoea also, overuse of antibiotics could lead to inflammation of the colon.