European Study Links Antibiotic Exposure to Increased Risk of Type 2 Diabetes Later in Life

Each course of antibiotics during young adulthood was associated with a 2-4% increase in risk of developing type 2 diabetes, according to the results of a new analysis.

Using data from the Cardiovascular Risk in Young Finns Study (YFS) and the national FINRISK study, investigators determined each additional exposure to an antibiotic course was associated with increased risk of subset type 2 diabetes in both studies, with exposure to 5 or more courses associated with a potential doubling in risk of type 2 diabetes later in life.

“The results of this study show that prior exposure to systemic antibiotics was associated with increased risk of incident type 2 diabetes in more than 25,000 participants. Furthermore, prior exposure to antibiotics was also associated with overweight/obesity. The observed risks persisted even after adjustment for numerous potential confounding factors, including BMI at baseline,” wrote investigators.

As more and more data emerge detailing the impact of antibiotic exposure on intestinal microbiome and overall health, some have hypothesized these changes could contribute to increased risk of developing diabetes. The current study was born out of an interest in exploring the potential impact of antibiotic exposure on type 2 diabetes risk using data from the YFS and FINRISK studies.

Launched in 1978, the YFS 2209 participants aged 24-39 years in 2001 with data available related to exposure to antibiotic courses from 1993-2001, which provided investigators with information from 2209 individuals. Of these, 110 patients were diagnosed with diabetes. Using information obtained from clinical examinations conducted in 2001, 2007, and 2011, investigators assessed prevalence of diabetes beginning in and after 2001, with those with prevalent diabetes excluded from the analyses. For the purpose of analysis, investigators used 4 population-based cohorts derived from the National FINRISK studies for replication. These 4 population-based cohorts included 24,674 individuals. Of these, 1866 had incident diabetes. Overall, the total study cohort included 26,883 participants.

Upon analysis, investigators found prior antibiotic exposure, which was defined as more than 5 antibiotic courses, was associated with an increased likelihood of developing type 2 diabetes in both the YFS (OR, 2.29 [95% CI, 1.33-3.96]) and the FINRISK cohorts (HR, 1.73 [95% CI 1.51-1.99]) compared to their counterparts with 1 or fewer antibiotic course exposures. When assessing the impact of exposure per course, results indicated each antibiotic course was associated with a 4% increase in likelihood of type 2 diabetes in the YFS cohort (OR, 1.043 [95% CI, 1.013-1.074]) and a 2% increase in likelihood in the FINRISK cohort (HR, 1.022 [95% CI, 1.016-1.029]).

Further analysis, which assessed risk of overweight/obesity associated with exposure to antibiotics, suggested exposure to antibiotics was associated with a 4% increase in likelihood of overweight/obesity in the YFS cohort (OR, 1.043 [95% CI, 1.019-1.068]) at the 10-year follow-up and a 2% increase in likelihood of overweight/obesity in the FINRISK cohort (OR, 1.023 [95% CI, 1.018-1.029]) at baseline. Investigators pointed out additional adjustments for confounders from early life in YFS and at baseline in FINRISK did not have an appreciable impact on the aforementioned findings.

“We found that prior exposure to systemic antibiotics was associated with increased risk for future type 2 diabetes and overweight and obesity. Our findings support judicious use of antibiotics. Future studies are needed to further investigate the relationship between antibiotic exposure and type 2 diabetes and excess body weight as well as to examine the direct impact of antibiotic exposure on human gut microbiome.”

This study, “Use of antibiotics and risk of type 2 diabetes, overweight and obesity: the Cardiovascular Risk in Young Finns Study and the national FINRISK study,” was published in BMC Endocrine Disorders.