Hydroxychloroquine in Decompensated, Treatment-Refractory Noninsulin-Dependent Diabetes Mellitus

Quatraro, A

doi:10.7326/0003-4819-112-9-678

Cited by 149 publications

(100 citation statements)

References 12 publications

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“…14 Antimalarials also have been shown to lower glycated hemoglobin levels in patients with type 2 diabetes who have suboptimal glucose control. 12 In addition, the prevalence of diabetes in patients with rheumatoid arthritis is similar to that of other patients, even though patients with rheumatoid arthritis are more sedentary and often treated with corticosteroids that induce weight gain. 15,16 This study was designed to investigate the association between hydroxychloroquine therapy and risk of incident diabetes in patients with rheumatoid arthritis.…”

mentioning

confidence: 81%

“…24,25 Antimalarial agents have been reported to cause both symptomatic and asymptomatic hypoglycemia. 10,12,13,26 Antimalarials also have been explored as an adjunct to insulin and oral hypoglycemic agents for poorly controlled type 2 diabetes. 12,26 Patients with non-insulindependent diabetes with suboptimal disease control during an intensive outpatient intervention showed an absolute reduction in glycated hemoglobin A 1c level of 3.3% when treated for 6 months with hydroxychloroquine dosed at 200 mg 3 times per day.…”

Section: Commentmentioning

confidence: 99%

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Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis

Wasko¹,

Hubert²,

Lingala³

et al. 2007

JAMA

257

159

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mentioning

confidence: 81%

Section: Commentmentioning

confidence: 99%

Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis

Wasko¹,

Hubert²,

Lingala³

et al. 2007

JAMA

257

159

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“…Methotrexate is thought to exert its effects through its anti-inflammatory action mediated through adenosine 60 which is known to enhance glucose metabolism through insulin and alters lipid metabolism. 61 Anti-TNF-α drugs have been shown to improve insulin resistance and insulin sensitivity 59 apart from decreasing inflammation while hydroxychloroquine decreases blood glucose levels 62 and total cholesterol levels. 63 But well designed studies comparing the prevalence of MetS in patients with RA on treatment with disease modifying antirheumatic drugs (DMARDs) and those who are treatment naïve are lacking.…”

Section: Rheumatoid Arthritis Metabolic Syndrome and Cardiovascular mentioning

confidence: 99%

Metabolic syndrome in patients with rheumatoid arthritis: clinical implications

B¹,

G²,

DT³

et al. 2013

JCSR

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Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by swelling, tenderness, and destruction of synovial joints, leading to severe disability and premature mortality. The severity of inflammation is linked to an increased risk of cardiovascular mortality in the affected persons. Patients with RA are more prone for accelerated atherosclerosis than the general population. Atherosclerosis is in turn a risk factor for cardiovascular disease (CVD). Metabolic syndrome (MetS) is a major risk factor for the development of CVD. Evaluation of patients with RA for MetS appears to be clinically relevent because, not only are patients with RA more prone to develop atherosclerotic CVD, but when an associated MetS coexists this risk is further amplified. Investigations into the relationship between RA and the MetS have yielded conflicting results. While some studies reported a higher prevalence of MetS in patients with RA, others did not document such association. It has also been demonstrated that drugs which decrease rheumatoid inflammation are also useful in decreasing the MetS component of the disease.

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“…10 (Table 5) Another study by Quatraro et al showed decreased insulin requirements in diabetic patients receiving HCQ with the C peptide levels remaining the same. 16 Inhibitory effect on insulin metabolism in animal models and in vitro studies have also been documented with evidence of decreased degradation and intracellular accumulation. 14,15,17 Chloroquine analogues have plasma lipid-lowering effects in diabetes mellitus, RA, SLE and dyslipidaemia that are therapeutically relevant due to the increased risks of premature atherosclerosis in these diseases.…”

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confidence: 99%

Efficacy of hydroxychloroquine as a potential antidiabetic drug

Kumar

Kamath

Reddy

2017

Int J Basic Clin Pharmacol

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Background: India is the world’s diabetic capital. Oral antidiabetic therapy is still incomplete. Prior studies have shown that hydroxychloroquine (HCQ), a commonly used antimalarial, anti-rheumatic drug reduces the risk of developing diabetes mellitus. It probably acts by decreasing insulin metabolism- a novel mechanism of action.Methods: A systematic search was done in MEDLINE database with key words ‘Type 2 Diabetes Mellitus’, ‘Hydroxychloroquine’. Articles assessing the antidiabetic efficacy of hydroxychloroquine were reviewed and their results summarized.Results: With extensive literature search, we found out three RCTs and four Cohort studies assessing the efficacy of HCQ on glycaemic markers in patients with type 2 diabetes mellitus. Two randomized controlled trials done by Gerstein H C et al, Pareek A et al, comparing hydroxychloroquine with established antidiabetic drugs showed that there is significant reduction in glycaemic parameters with comparable similarity in both the groups (HbA1c: -0.91%±0.4%). Solomon et al in their study on patients with RA concluded that HCQ improved insulin sensitivity. Two cohort studies by Chen Y M et al and Wasko MCM et al respectively showed reduced incidence of diabetes mellitus in Systemic lupus erythematosus (Hazard ratio=0.26) and rheumatologic disease (relative risk=0.23) patients who received hydroxychloroquine. In a cohort study by Rekedal LR et al, HCQ reduced HbA1c by 0.66% compared to baseline in patients with RA. These studies also showed that hydroxychloroquine has favourable effect on lipid profile and good tolerabilityConclusions: Hydroxychloroquine has a potential to enter antidiabetic armamentarium due to its efficacy and low toxicity profile. More studies are required to confirm this.

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Hydroxychloroquine in Decompensated, Treatment-Refractory Noninsulin-Dependent Diabetes Mellitus

Abstract: Combining antidiabetic therapy with hydroxychloroquine in decompensated, treatment-refractory patients with noninsulin-dependent diabetes may help to break the vicious circle of hyperglycemia and lead to better management of the disease.

Cited by 149 publications

References 12 publications

Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis

Hydroxychloroquine and Risk of Diabetes in Patients With Rheumatoid Arthritis

Metabolic syndrome in patients with rheumatoid arthritis: clinical implications

Efficacy of hydroxychloroquine as a potential antidiabetic drug

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