(HealthDay News) — Previous findings that systemic use of antibiotics increases the risk of diabetes may actually be explained by clinical and lifestyle factors, according to a study published in Diabetes, Obesity and Metabolism.

Ming Ye, PhD, from the University of Alberta in Canada, and colleagues assessed the association between systemic use of antibiotics and risk of diabetes in a cohort of adults (1676 diabetes cases and 13,401 controls) in Canada using linked administrative health records (2000 to 2015) and data from Alberta’s Tomorrow Project, a longitudinal cohort study.

The researchers found that while more cases than controls received at least 6 courses of antibiotics (17.9 versus 13.8%), the association between antibiotic use and risk of diabetes was progressively reduced when clinical and lifestyle factors were accounted for. In fully adjusted models, compared to participants with 0 or 1 course of antibiotics, those receiving more antibiotics did not have an increased risk of diabetes (odds ratio, 0.97; 95% confidence interval, 0.83 to 1.13 for 2 to 4 courses and odds ratio, 0.98; 95% confidence interval, 0.82 to 1.18 for 5 or more courses).

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“Our results suggest that those positive associations observed by previous studies using only administrative records might have been confounded,” conclude the authors.

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Ye M, Robson PJ, Eurich DT, Vena JE, Xu J-Y, and Johnson JA. Systemic Use of Antibiotics and Risk of Diabetes in Adults: A Nested Case-control Study of Alberta’s Tomorrow Project. Diabetes Obes Metab. 2017 Nov 20. doi:10.1111/dom.13163