Hydroxychloroquine: a diabetic drug in disguise?

Kang, Lydia; Mikuls, Ted R.; O'Dell, James Robert

doi:10.1136/bcr.08.2008.0654

Cited by 16 publications

(9 citation statements)

References 15 publications

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“…This has been also observed in a recent study of patients with Rheumatoid arthritis and SLE and observed in a case report from 2009 [16,17].…”

Section: Resultssupporting

confidence: 81%

A Case of Hydroxychloroquine Induced Hypoglycaemia in a Non-Diabetic Patient

Richard¹,

Doherty²

2018

J Rheum Dis Treat

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In 2009 a 70-year-old man was diagnosed with seropositive Rheumatoid Arthritis which mainly manifested as hand deformities. He had been solely taking methotrexate, 15 mg weekly, and hydroxychloroquine, 200 mg twice daily, for 7 years. He had no other relevant past medical history, was an ex-smoker and consumed approximately 4 units of alcohol per week. In December 2017, he complained of feeling intermittently weak and light headed. The patient who has a daughter with Type 1 diabetes mellitus, likened his

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“…This has been also observed in a recent study of patients with Rheumatoid arthritis and SLE and observed in a case report from 2009 [16,17].…”

Section: Resultssupporting

confidence: 81%

A Case of Hydroxychloroquine Induced Hypoglycaemia in a Non-Diabetic Patient

Richard¹,

Doherty²

2018

J Rheum Dis Treat

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“…It has long been recognized that quinoline antimalarials may have hypoglycemic effects, hypothesized to be due to changes in intracellular insulin metabolism in peripheral tissues [50]. There are case reports documenting hypoglycemia in hydroxychloroquine-treated patients with no prior diabetes [51, 52] and with type 2 diabetes [53–55]. …”

Section: Diabetes-specific Effects Of Rheumatologic Immune Modulatorsmentioning

confidence: 99%

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

et al. 2016

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Immune modulators used to treat rheumatologic disease have diverse endocrine effects in patients with diabetes. Providers should be aware of these effects given that diabetes and rheumatologic disease overlap in prevalence and cardiovascular morbidity. In patients with type 1 diabetes, clinical trials have demonstrated that immune modulators used early in the disease can improve pancreatic function, though their efficacy in adults with longstanding autoimmune diabetes is unknown. In patients with type 2 diabetes, hydroxychloroquine is an effective antihyperglycemic and may be preferred for rheumatologic use in patients with difficult glycemic control. In patients without diabetes, hydroxychloroquine and tumor necrosis factor (TNF) inhibitors have been found to decrease diabetes incidence in observational studies. Additionally, dapsone and sulfasalazine alter erythrocyte survival resulting in inaccurate HbA1c values. These multifaceted effects of immune modulators create a need for coordinated care between providers treating patients with diabetes to individualize medication selection and prevent hypoglycemic events. More research is needed to determine the long-term outcomes of immune modulators in patients with diabetes.

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“…The patient had a subsequent decrease in his insulin requirements by 37% [Shojania et al 1999]. Another report emphasizing the glucose-lowering effect of HCQ is that describing a case of hypoglycemia in a patient with SLE and T2DM after initiation of HCQ at a dose of 200 mg twice daily with eventual discontinuation of her subcutaneous insulin [Kang et al 2009].…”

Section: Antimalarials and Effects On Glucose Metabolismmentioning

confidence: 99%

A favorable effect of hydroxychloroquine on glucose and lipid metabolism beyond its anti-inflammatory role

Hage

Al‐Badri

Azar

2014

Therapeutic Advances in Endocrinology

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Hydroxychloroquine (HCQ), a commonly used antimalarial drug in rheumatic diseases, has shown favorable metabolic effects on both glucose control and lipid profiles. We describe a case of a young woman with type 1 diabetes whose glycemic control was optimized with the introduction of HCQ as a treatment for her Sjogren syndrome in addition to a subtle yet measurable improvement in her lipid profile. An increasing body of evidence supports the beneficial impacts of HCQ in various ancillary conditions, including diabetes mellitus and dyslipidemia. However, mechanisms of action responsible for these effects remain ill-defined and may include alterations in insulin metabolism and signaling through cellular receptors. These favorable metabolic effects of HCQ and further understanding of underlying mechanisms may provide an additional rational for its use in rheumatic diseases, conditions associated with an elevated cardiovascular risk.

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Hydroxychloroquine: a diabetic drug in disguise?

Cited by 16 publications

References 15 publications

A Case of Hydroxychloroquine Induced Hypoglycaemia in a Non-Diabetic Patient

A Case of Hydroxychloroquine Induced Hypoglycaemia in a Non-Diabetic Patient

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

A favorable effect of hydroxychloroquine on glucose and lipid metabolism beyond its anti-inflammatory role

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