Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Aug 25, 2015; 6(10): 1122-1131
Published online Aug 25, 2015. doi: 10.4239/wjd.v6.i10.1122
Effect of proton pump inhibitors on glycemic control in patients with diabetes
Kohzo Takebayashi, Toshihiko Inukai
Kohzo Takebayashi, Toshihiko Inukai, Department of Internal Medicine, Dokkyo Medical University Koshigaya Hospital, Koshigaya, Saitama 343-8555, Japan
Author contributions: Takebayashi K wrote this manuscript; Inukai T reviewed the manuscript.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kohzo Takebayashi, MD, Department of Internal Medicine, Dokkyo Medical University Koshigaya Hospital, 2-1-50 Minamikoshigaya, Koshigaya, Saitama 343-8555, Japan. takeb@gmail.plala.or.jp
Telephone: +81-48-9651111 Fax: +81-48-9651127
Received: April 29, 2015
Peer-review started: May 3, 2015
First decision: June 24, 2015
Revised: July 6, 2015
Accepted: July 24, 2015
Article in press: July 27, 2015
Published online: August 25, 2015
Abstract

Gastrin is a linear peptide hormone which is secreted mostly in the stomach pyloric antrum G cells. Although the main role of this hormone is the promotion of the secretion of gastric acid from the stomach parietal cells, gastrin can also behave as a growth factor and stimulate gastric cell proliferation. It is also reported that gastrin promotes β cell neogenesis in the pancreatic ductal complex, modest pancreatic β cell replication, and improvement of glucose tolerance in animal models, in which the remodeling of pancreatic tissues is promoted. These findings suggest the possibility that gastrin has the potential to promote an increase of β cell mass in pancreas, and therefore that gastrin may improve glucose tolerance. Proton pump inhibitors (PPIs) are wildly used clinically for the therapy of gastro-esophageal reflex disease, gastritis due to excess stomach acid, and gastric ulcers. PPIs indirectly elevate serum gastrin levels via a negative feedback effect. Recent evidence has revealed the beneficial effect of PPIs on glycemic control especially in patients with type 2 diabetes mellitus (T2DM), probably via the elevation of the levels of serum gastrin, although the detailed mechanism remains unclear. In addition, the beneficial effects of a combination therapy of gastrin or a PPI with a glucagon-like peptide-1 receptor agonist on glycemic control in animal models have been demonstrated. Although PPIs may be possible candidates for a new approach in the therapy of diabetes, a prospective, long-term, randomized, double-blind, placebo-controlled study is needed to establish the effect of PPIs on glycemic control in a large number of patients with T2DM.

Keywords: Gastrin, Proton pump inhibitors, Glycemic control, Type 2 diabetes

Core tip: Recently, it is reported that gastrin may improve glucose tolerance mainly by the promotion of pancreatic β cell neogenesis. Proton pump inhibitors (PPIs) are wildly used clinically for the treatment such as gastric ulcers, and it is known that PPIs indirectly elevate serum gastrin levels. Recent evidence has showed the beneficial effect of PPIs on glycemic control especially in patients with type 2 diabetes, probably via the elevation of serum gastrin levels. Therefore, PPIs may have the potential to be candidates for a new approach in the treatment of diabetes.