From the Guidelines
Lyrica (pregabalin) has been shown to have a potential impact on blood glucose levels, particularly in patients with diabetes, and its use should be carefully monitored in these patients. According to a recent study published in 2023 1, pregabalin is one of the gabapentinoids that can be considered in the treatment of pain in diabetic neuropathy (DPN). While the study does not specifically address the effect of Lyrica on blood glucose levels, it highlights the importance of careful management of pain in DPN, which can have a significant impact on quality of life.
When considering the use of Lyrica in patients with diabetes, it is essential to monitor blood glucose levels regularly, especially when starting the medication or changing doses. This is because Lyrica may affect insulin secretion and glucose metabolism, potentially leading to decreased blood glucose levels. Patients with diabetes may need to adjust their diabetes medications to avoid hypoglycemia.
Some key points to consider when using Lyrica in patients with diabetes include:
- Monitoring blood glucose levels regularly, especially when starting or changing doses of Lyrica
- Being aware of the potential for decreased blood glucose levels, which may require adjustments to diabetes medications
- Informing all healthcare providers about the use of Lyrica to ensure proper monitoring of potential interactions
- Reporting any unusual symptoms, such as dizziness, confusion, or sweating, which may indicate hypoglycemia, to the healthcare provider immediately.
It is crucial to weigh the benefits of using Lyrica in patients with diabetes against the potential risks, including the impact on blood glucose levels. However, for non-diabetic patients, the risk of significant blood glucose changes is generally low, and they should still report any unusual symptoms to their doctor. Overall, the use of Lyrica in patients with diabetes requires careful monitoring and management to minimize the risk of adverse effects on blood glucose levels.
From the FDA Drug Label
Although weight gain was not associated with clinically important changes in blood pressure in short-term controlled studies, the long-term cardiovascular effects of pregabalin-associated weight gain are unknown. Among diabetic patients, pregabalin-treated patients gained an average of 1.6 kg (range: -16 to 16 kg), compared to an average 0. 3 kg (range: -10 to 9 kg) weight gain in placebo patients. In a cohort of 333 diabetic patients who received pregabalin for at least 2 years, the average weight gain was 5. 2 kg. While the effects of pregabalin-associated weight gain on glycemic control have not been systematically assessed, in controlled and longer-term open label clinical trials with diabetic patients, pregabalin treatment did not appear to be associated with loss of glycemic control (as measured by HbA1C).
Pregabalin treatment does not appear to be associated with loss of glycemic control in diabetic patients, as measured by HbA1C 2. However, the effects of pregabalin-associated weight gain on glycemic control have not been systematically assessed. Key points include:
- Pregabalin-treated diabetic patients gained an average of 1.6 kg
- Average weight gain in a cohort of 333 diabetic patients was 5.2 kg over at least 2 years
- No association with loss of glycemic control was found in controlled and longer-term open label clinical trials
From the Research
LYRICA and Blood Glucose
- The effect of Lyrica (pregabalin) on blood glucose levels is not directly addressed in the provided studies 3, 4, 5, 6, 7.
- However, study 7 compares the therapeutic effects of pregabalin, gabapentin, and duloxetine in diabetic peripheral neuropathy and reports that duloxetine significantly lowered HbA1c levels compared to gabapentin and pregabalin.
- The study suggests that duloxetine may be a better option for patients with well-controlled HbA1c, while gabapentin and pregabalin may be more suitable for patients with higher HbA1c levels 7.
- Study 4 and 6 report on the efficacy and tolerability of duloxetine, pregabalin, and gabapentin in patients with diabetic peripheral neuropathic pain, but do not provide direct information on the effect of Lyrica on blood glucose levels 4, 6.
- Study 3 provides information on the pharmacology and therapeutic use of pregabalin, but does not address its effect on blood glucose levels 3.
- Study 5 conducts a meta-analysis to compare the efficacy and tolerability of duloxetine, pregabalin, and gabapentin in the treatment of diabetic peripheral neuropathic pain, but does not provide information on the effect of Lyrica on blood glucose levels 5.