Concomitant use of benzodiazepines and oral glucose-lowering drugs in patients with type-2 diabetes

Introduction: In diabetic patients undergoing treatment with oral glucose-lowering drugs (GLD), greater-than-expected decreases were observed in pre-meal blood sugar levels.

Objective: In type 2 diabetic patients taking oral glucose-lowering drugs, evaluate the relationship between the effect of taking benzodiazepines and the patient's self-monitored pre-meal glucose level in relation to hypoglycemia.

Methods: A cross-sectional, descriptive, observational study was conducted in a community pharmacy in the city of Córdoba (Argentina). Averages of pre-meal blood sugar levels were used. Subjects were divided into two groups: with and without concomitant prescription of benzodiazepines. The groups were compared using Student's t-test.

Results: Metformin was the most prescribed oral GLD (n=42) as a monotherapy or adjunctive therapy, most frequently combined with alprazolam (n=9) and diazepam (n=5). The most frequently prescribed benzodiazepines were alprazolam (15 patients) and diazepam (13 patients). Diazepam was the benzodiazepine that most effectively lowered the glucose level (n=8), followed by alprazolam (n=7). In the group where both drugs were prescribed, there is a decrease to hypoglycemic levels (less than 70 mg/dl) in the pre-meal blood sugar levels of 15 (35%) patients.

Conclusions: The use of benzodiazepines together with oral GLD in this group of type 2 diabetic patients resulted in better control of the pre-meal glucose levels than in the group for which only GLD monotherapy was used. However, due to the methodological limitations of the study, a direct link cannot be concluded.