Table 1.

Medications associated with hyperglycemia by medication groups

Drug class	Sample agents	Proposed mechanisms for hyperglycemia
Anti-inflammatory, antineoplastic and immunomodulatory drugs
Glucocorticoids	Hydrocortisone Prednisone Dexamethasone	Increased insulin resistance Increased gluconeogenesis Decreased insulin production Weight gain Upregulation of the effect of glucagon and epinephrine
L-asparaginase	L-asparaginase	Decreased insulin synthesis β cell damage Impairment in insulin receptor function Hyperglucagonemia
Calcineurin inhibitor	Tacrolimus Cyclosporine	Decreased insulin secretion
mTOR inhibitors	Sirolimus	Decreased insulin secretion Increased insulin resistance
Monoclonal antibody	Basiliximab	Increased islet autoimmunity
Checkpoint inhibitors	Nivolumab and pembrolizumab	Increased islet autoimmunity
Neurologic and psychiatric drugs
γ aminobutyric acid Inhibitors	Valproic acid	Weight gain Increased insulin resistance
Voltage gated sodium channel blockers	Phenytoin	Decreased insulin secretion Increased insulin resistance
α-2-adrenergic agonists	Clonidine	Decreased insulin secretion
Atypical antipsychotics	Quetiapine Olanzapine Risperidone Aripiprazole Ziprasidone	Increased insulin resistance Weight gain Decreased insulin secretion
Cardiovascular and renal drugs
Thiazide diuretics	Multiple	Increased insulin resistance Decreased insulin secretion
β-blockers	Multiple	Decreased insulin secretion Increased insulin resistance
Class III antiarrhythmics	Amiodarone	Unknown
Prostaglandins	PGE 1	Decreased insulin secretion Increased glucagon secretion
HMG-CoA reductase inhibitors (statins)	Multiple	Increased insulin resistance Decreased insulin secretion
Vitamin B3	Niacin	Increased glucose production Increased insulin resistance
Endocrinologic drugs
Growth hormone	Growth hormone	Increased insulin resistance Increased gluconeogenesis
Hormonal contraceptives	Multiple	Decreased insulin secretion Increased insulin resistance
Somatostatin analogs	Octreotide Pasireotide	Decreased insulin secretion
Potassium channel activator	Diazoxide	Decreased insulin secretion
Anti-infective drugs
Fluoroquinolones	Ciprofloxacin Gemifloxacin Levofloxacin Moxifloxacin Ofloxacin	Decreased insulin secretion
Antiprotozoals  Antifungals	Pentamidine	Decreased insulin secretion
Protease inhibitors	Ritonavir Nelfinavir Indinavir	Decreased insulin secretion Increased insulin resistance
Nucleoside reverse transcriptase inhibitors	Didanosine Abacavir	Mitochondrial toxicity
Respiratory drugs
β-2-agonists	Multiple	Increased glucogenolysis and gluconeogenesis
Phosphodiesterase inhibitor	Theophylline	Increased catecholamines

HMG-CoA, 3-hydroxy-3-methyl-glutaryl-coenzyme A; mTOR, mammalian target of rapamycin; PGE1, prostaglandin 1.