Are proton pump inhibitors a new antidiabetic drug? A cross sectional study.

AIM: To investigate the effect of proton pump inhibitors (PPIs) on glycemic control (HbA1c) in type 2 diabetic patients. METHODS: A cross-sectional study of consecutive in-patients admitted to hospital in any department during the first semester of the year 2010 who had a recent HbA1c measurement. The study excluded those with a diagnosis of hyperglycemic decompensation, diabetic onset or pregnancy. It compared HbA1c levels of those taking PPIs and those not. RESULTS: A total of 97 patients were recruited. The average HbA1C level was 7.0% ± 1.2%. Overall PPI consumption was 55.7%. HbA1c was significantly lower in individuals who took PPIs: -0.6%, 95% CI: -0.12 to -0.83. People who used PPIs with some type of insulin therapy had a HbA1c reduction by -0.8%, 95% CI: -0.12 to -1.48. For the rest of subgroup analysis based on the antidiabetic drug used, PPI consumption always exhibited lower HbA1c levels. CONCLUSION: PPIs seems to be consistently associated with better glycemic control in type 2 diabetes. HbA1c reduction observed is similar to incretin-based therapies.

Cardiac biomarkers and exercise duration and intensity during a cycle-touring event.

OBJECTIVE: To determine the influence of age, training status, race time, and exercise intensity on the appearance of cardiac biomarkers after a cycle-touring event. DESIGN: Pre-post exercise measurements. SETTING: University of Zaragoza, Zaragoza, Spain. PARTICIPANTS: Ninety-one amateur cyclists. INTERVENTION: The 2005 Quebrantahuesos cycle-touring event (distance: 206 km; altitude difference: 3800 m). MAIN OUTCOME MEASURES: Cardiac troponin I (cTnI) and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) were measured the day before and immediately after the race. Heart rate (HR) monitoring was performed on 55 cyclists during the race to evaluate exercise intensity. RESULTS: cTnI and NT-pro-BNP were significantly elevated immediately post race, with 43% of participants exhibiting cTnI levels greater than 0.04 microg/L and 65% of the participants measuring NT-pro-BNP levels greater than 125 ng/L. The cTnI increase was significantly associated with mean exercise intensity HR (r = 0.36, P < 0.01) but was not associated with age, training status, or race time. The increase in NT-pro-BNP correlated with race time (r = 0.40, P < 0.001) and training status (r = -0.36, P < 0.001) but was not associated with age or exercise intensity HR measures. CONCLUSIONS: These results suggest that, in part, exercise intensity (HR) is responsible for the cTnI increase and that race time is responsible for the increase in NT-pro-BNP. Future standardized endurance exercise trials are recommended to further elucidate the potentially differential effects of training status, exercise time, and intensity on post-exercise increases in cTnI and NT-pro-BNP.

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