Predictors of Diabetes Mellitus and Abnormal Blood Glucose in Patients Receiving Opioid Maintenance Treatment

Authors

  • Ayman Fareed MD,

    Corresponding author
    1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
    • Atlanta Veterans Administration Medical Center, Decatur, Georgia
    Search for more papers by this author
  • Johnita Byrd-Sellers MS,

    1. Atlanta Veterans Administration Medical Center, Decatur, Georgia
    Search for more papers by this author
    • Johnita Byrd-Sellers, MS is now affiliated with Emory University School of Medicine Department of Surgery, Emory Transplant Center.
  • Sreedevi Vayalapalli MD,

    1. Atlanta Veterans Administration Medical Center, Decatur, Georgia
    2. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
    Search for more papers by this author
  • Karen Drexler MD,

    1. Atlanta Veterans Administration Medical Center, Decatur, Georgia
    2. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
    Search for more papers by this author
  • Lawrence Phillips MD

    1. Atlanta Veterans Administration Medical Center, Decatur, Georgia
    2. Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
    Search for more papers by this author

Address correspondence to Dr. Fareed, Atlanta VA Medical Center 116A, 1670 Clairmont Rd., Decatur, GA 30033. E-mail: ayman.fareed@va.gov.

Abstract

Background

Buprenorphine is a partial opioid agonist and may have less impact on the risk of developing diabetes mellitus (DM) compared to full opioid agonists like methadone.

Methods

We conducted an observational retrospective study to investigate the predictable factors for impaired glucose tolerance and predisposition to DM in two groups of opiate addicts receiving long-term methadone maintenance treatment (MMT) [n = 58] or buprenorphine maintenance treatment (BMT) [n = 61].

Results

In our cohort, being African American, hepatitis C positive status, elevated AST, and ALT, and being on methadone were significantly correlated to being diagnosed with DM. Among all those factors, being on methadone was most significantly related to being diagnosed with DM (χ2 = 3.9888, p-value = .0458). The BMI was the only factor that was significantly correlated to having abnormal A1c level (χ2 = 6.4229, p-value = .0113).

Conclusions

Buprenorphine may be less likely to contribute to the development of DM than methadone. More research is needed to understand the link between opioids and DM. (Am J Addict 2013;22:411–416)

Ancillary