When therapeutic drugs lead to diabetes – published online 04/03/2022

Bruno Fève and André J. Scheen

Drug-induced diabetes is not a novel concern, and this is examined in this issue by Fève and Scheen (https://doi.org/10.1007/s00125-022-05666-w). The archetype of this iatrogenic complication is glucocorticoid-induced diabetes, which remains the most frequently encountered one in clinical practice. However, we should not overlook the high prevalence of diabetes caused by antipsychotics, in particular by second generation compounds. The pharmacopoeia of antiretrovirals has greatly improved since the first classes of these drugs became available at the end of the 1980s; however, there is still a residual metabolic toxicity of several new generation molecules. Even more recently, the advent of immunotherapies in oncology has been accompanied by the emergence of diabetes cases that are reminiscent of the phenotype of type 1 diabetes. This short review is focused on these four families of diabetogenic drugs, and will provide information on the prevalence of this complication, the main clinical presentations and the key pathophysiological mechanisms, before addressing the management and prevention of these chemically induced forms of diabetes. The figure from this review is available as a downloadable slide.

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