ELEVATED HEMOGLOBIN-A1C AND LOW-DENSITY LIPOPROTEIN CHOLESTEROL LEVELS IN THIAZIDE-TREATED DIABETIC-PATIENTS

Despite the well-known hyperglycemia effect of thiazide diuretics, these agents are often administered to diabetic patients. This study compared 89 insulin-treated diabetic patients receiving hydrochlorothiazide, 57 receiving furosemide, and 255 receiving no diuretic.H A1c level was 7.2 .+-. 1.8% (mean .+-. SD) with hydrochlorothiazide, significantly higher than the levels of 5.9 .+-. 2.3 percent with furosemide and 6.4 .+-. 2.0 percent with no diuretic. Low-density lipoprotein cholesterol levels was 154 .+-. 43 mg/dl with hydrochlorothiazide, but 134 .+-. 42 mg/dl with furosemide and 130 .+-. 42 mg/dl with no diuretic. Multivariate analysis showed that the associations remained significant after adjustment for age, sex, race, type and duration of diabetes, body mass index, blood pressure, serum K level, insulin dose and treatment with other medications. Treatment with thiazide diuretics in the diabetic population may increase low-density lipoprotein cholesterol and Hb A1c levels.