Thiazide diuretics have which metabolic risk?

Thiazide diuretics have which metabolic risk?

• A. They have no effect on glucose metabolism
• B. They improve insulin sensitivity
• C. They can cause hypoglycemia
• D. They can cause hyperglycemia

Answer: (D)

Thiazide diuretics can worsen glucose tolerance and raise blood sugar levels. They promote potassium loss (hypokalemia), and lower potassium impairs pancreatic insulin secretion and reduces insulin effectiveness in peripheral tissues. This combination can lead to hyperglycemia, especially at higher doses or in patients who already have risk factors for diabetes. That’s why the metabolic risk is hyperglycemia. They do not typically cause hypoglycemia, and they do not improve insulin sensitivity; they do affect glucose metabolism, generally by raising glucose rather than lowering it.

Thiazide diuretics can worsen glucose tolerance and raise blood sugar levels. They promote potassium loss (hypokalemia), and lower potassium impairs pancreatic insulin secretion and reduces insulin effectiveness in peripheral tissues. This combination can lead to hyperglycemia, especially at higher doses or in patients who already have risk factors for diabetes. That’s why the metabolic risk is hyperglycemia. They do not typically cause hypoglycemia, and they do not improve insulin sensitivity; they do affect glucose metabolism, generally by raising glucose rather than lowering it.