Current Diabetes Reports

, 18:6 | Cite as

Type 2 Diabetes and Thiazide Diuretics

  • André J. ScheenEmail author
Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Other Forms of Diabetes and Its Complications


Purpose of Review

In patients with prediabetes or type 2 diabetes, the use of thiazides as antihypertensive agents has been challenged because associated metabolic adverse events, including new-onset diabetes.

Recent Findings

These metabolic disturbances are less marked with low-dose thiazides and, in most but not all studies, with thiazide-like diuretics (chlorthalidone, indapamide) than with thiazide-type diuretics (hydrochlorothiazide). In post hoc analyses of subgroups of patients with hypertension and type 2 diabetes, thiazides resulted in a significant reduction in cardiovascular events, all-cause mortality, and hospitalization for heart failure compared to placebo and generally were shown to be non-inferior to other antihypertensive agents.


Benefits attributed to thiazide diuretics in terms of cardiovascular event reduction outweigh the risk of worsening glucose control in type 2 diabetes and of new-onset diabetes in non-diabetic patients. Thiazides still play a key role in the management of patients with type 2 diabetes and hypertension.


Cardiovascular disease Diuretic Hypertension SGLT2 inhibitor Thiazide Type 2 diabetes 


Compliance with Ethical Standards

Conflict of Interest

No sources of funding were used to assist in the preparation of this manuscript. No conflicts of interest are directly relevant to the content of this manuscript.

A.J. Scheen has received lecturer/scientific advisor/clinical investigator fees from AstraZeneca, Boehringer Ingelheim, Eli Lilly, Janssen, Merck Sharp & Dohme, NovoNordisk, Sanofi, and Servier.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.


Papers of particular interest, published recently, have been highlighted as: •Of importance •• Of major importance

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Authors and Affiliations

  1. 1.Division of Diabetes, Nutrition and Metabolic Disorders, Department of Medicine, CHU LiègeUniversity of LiègeLiegeBelgium
  2. 2.Clinical Pharmacology Unit, CHU Liège, Center for Interdisciplinary Research on Medicines (CIRM)University of LiègeLiègeBelgium

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