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Long-term use of proton pump inhibitors (PPIs) is associated with an increased risk of type 2 diabetes
  1. Sven H Loosen1,
  2. Karel Kostev2,
  3. Mark Luedde3,
  4. Natalia Qvartskhava1,
  5. Tom Luedde1,
  6. Christoph Roderburg1
  1. 1 Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany
  2. 2 Epidemiology, IQVIA, Frankfurt, Germany
  3. 3 Department of Internal Medicine, Christian Albrechts University of Kiel, Kiel, Germany
  1. Correspondence to Dr Sven H Loosen, Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Dusseldorf, Germany; Sven.Loosen{at}

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We read with great interest the work of Yuan et al 1 providing robust evidence for an association between a regular use of proton pump inhibitors (PPIs) and the risk of type 2 diabetes (T2D). In a retrospective case–control study, we used the Disease Analyser database (IQVIA), which compiles drug prescriptions, diagnoses and basic medical and demographic data obtained from general practitioners (GPs) in Germany,2 to evaluate an association between long-term PPI therapy and diagnosis of T2D. A total of 26 744 patients aged ≥18 years with an initial diagnosis of T2D (index date) between January 2010 and December 2020 from 752 GP practices were included. Inclusion criteria included at least one body mass index (BMI) value at baseline and an observation time of at least 12 months prior to the index date. As a control population, GP patients who fulfilled the inclusion criteria but had no diagnosis of T2D in their entire medical history were matched 1:1 to patients with T2D based on propensity scores delivered from logistic …

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  • SHL and KK are joint senior authors.

  • TL and CR are joint senior authors.

  • Contributors SHL and CR designed the study; KK performed statistical analyses and generated tables; SHL and CR wrote the manuscript; TL, ML and NQ provided intellectual input and corrected the manuscript. All authors agreed to the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.