Patients with diabetes who were managing opioid addiction with buprenorphine-naloxone substitution therapy had decreases in their glycated HbA1c values, according to findings recently published in Canadian Family Physician.
“Both opioid use disorders and [type 2 diabetes mellitus] are chronic medical illnesses in which noncompliance with treatment is a common problem influenced by psychosocial factors,” Devon Tilbrook, MD, CCFP, a physician practicing in Sioux Lookout, Ontario, Canada, and colleagues wrote. “Different treatment methods for opioid use disorders have varying effects on diabetes control.”
To gauge the effect of buprenorphine-naloxone substitution therapy in patients with diabetes, Tilbrook and colleagues studied HbA1c levels in 573 indigenous peoples of First Nations communities in Ontario. Sixty-two patients were also taking opioid substitution therapy; the remaining patients served as a control group. HbA1c levels were recorded from July to December 2013, and again from January to July 2015.
Tilbrook and colleagues found that the absolute difference between the HbA1c levels between the two groups was 1.22% (P = .011). The substitution therapy group’s average change in HbA1c level was an absolute decrease of 1.2%. Conversely, patients in the control group experienced an average absolute increase in their HbA1c levels of 0.02%.
“Treating opioid use disorder with buprenorphine-naloxone substitution therapy has an unintended positive effect on diabetes management,” researchers wrote. “Perhaps participation in buprenorphine programs will reduce disease burden and diabetes complications in the long term.”
“While it is possible that some of the effect might be medication-related, such a large effect is likely owing to improved self-care and improved adherence to treatment of all health issues, as previous research on the pharmacobiology of buprenorphine administration did not find such a large effect,” Tilbrook and colleagues continued. “It is conceivable that patients participating in these programs also have more contact with health care professionals in regard to substance use disorders and might therefore receive improved follow-up of other health issues such as diabetes.” – by Janel Miller
The researchers report no relevant financial disclosures.