PPI use associated with decreased new-onset diabetes risk in Korean NHIS-HEALS cohort

Abstract

Abstract Several studies investigating the association between PPI use and new-onset diabetes mellitus (NODM) reported conflicting results. Herein, the association between PPI prescription and NODM in Koreans was examined. This study used the National Health Insurance Service-Health Screening cohort (NHIS-HEALS) database to identify adults ≥ 40 years without a history of diabetes. The dose of each PPI was converted into an omeprazole equivalent (OME) dose. Cumulative PPI prescriptions were categorized into four groups according to the OME dose: non-users, 1st tertile (T1), 2nd tertile (T2), and 3rd tertile (T3). We estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) for NODM using multivariate Cox proportional hazards regression analysis. During 9.8 years of mean follow-up for 82,590 participants, 9,464 (11.5%) developed NODM. Compared to non-users, the full adjusted HRs (95% CIs) of the T1, T2, and T3 for NODM were 0.57 (0.53 − 0.62), 0.55 (0.51 − 0.59), and 0.48 (0.45 − 0.52), in men and 0.62 (0.56 − 0.68), 0.57 (0.51 − 0.63), and 0.46 (0.41 − 0.51), in women, respectively (all p < 0.001). These trends were observed after stratifying the entire population into statin users and non-users or individuals with normoglycemia and impaired fasting glucose. Therefore, cumulative PPI prescription doses were associated with a lower risk of NODM in Korean adults.