Regular use of ibuprofen or paracetamol and incident type 2 diabetes: A prospective cohort study in the UK Biobank

Background: The relation of regular ibuprofen or paracetamol use with the risk of type 2 diabetes (T2DM) remained undetermined. We aimed to evaluate the prospective association between regular ibuprofen or paracetamol use and incidence of T2DM.Methods: This cohort included 372,843 participants with available data of ibuprofen, paracetamol use and without diabetes at baseline from the UK Biobank. The primary outcome was incident T2DM. Cox propor-tional hazards models were applied to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for the risk of T2DM.Results: During a median of 12.1 years' follow-up, 11,527 (3.1%) participants developed T2DM. Overall, partic-ipants with regular use of paracetamol showed a significantly higher risk of incident T2DM (adjusted HR, 1.25; 95%CI: 1.19,1.31), compared with non-users. Moreover, a stronger positive association of paracetamol use with incident T2DM was found among those aged <60 years (vs. >= 60 years, P-interaction =0.008), free of cardiovascular diseases (CVD) (vs. CVD patients, P-interaction =0.01), and without the use of anti -hyperten-sive drugs (vs. users, P-interaction =0.016) at baseline. However, there was no significant association between regular use of ibuprofen (users vs. non-users; adjusted HR, 1.05; 95%CI: 0.99,1.12) and incident T2DM. More importantly, genetic risks of T2DM did not significantly modify the relations of ibuprofen, or paracetamol use with incident T2DM (Both P-interactions >0.05). Conclusions: Regular use of paracetamol, but not ibuprofen, was associated with a significantly higher risk of incident T2DM among middle aged UK adults. Our current findings highlight the need for greater consider-ation in the clinical selection of paracetamol or ibuprofen.(c) 2022 Elsevier Masson SAS. All rights reserved.