Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus
International Journal of Diabetes and Endocrinology
Volume 3, Issue 4, December 2018, Pages: 58-62
Received: Nov. 25, 2018; Accepted: Dec. 11, 2018; Published: Jan. 7, 2019
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Abhishek Kumar Chandra, Department of Medicine, Kurji Holy Family Hospital, Patna, India
Sajjad Ahsan, Department of Endocrinology, Indira Gandhi Institute of Medical Science, Patna, India
Prakash Ranjan, The National Institute of Health and Family Welfare, New Delhi, India
Ajeet Kumar Sinha, Head of the Department, Department of Medicine, Kurji Holy Family Hospital, Patna, India
Rajeev Ranjan Kumar, Department of Medicine, All India Institute of Medical Sciences, Patna, India
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The aim of the study was to evaluate the clinical safety and efficacy of hydroxychloroquine in subjects with were poorly controlled type 2 diabetes mellitus (T2DM), despite treatment with insulin glargine and a combination of gliclazide and metformin. 105 patients with type 2 DM, mean age 56.84 years and mean body mass index (BMI) 26.30 kg/m2, were enrolled in this multicentre open label trial. They were given hydroxychloroquine 400 mg/day in addition to previous treatment with insulin glargine (≥30 units a day), gliclazide (80 mg a day) and metformin (1000 mg a day) for a period of six months. Hydroxychloroquine 400 mg/day, when added to insulin glargine and the combination of gliclazide and metformin, significantly decreased hemoglobin A1c (HbA1c) at six months from a mean of 8.15±0.24 to a mean of 6.69±0.42 (p<0.0001) and fasting plasma glucose (FPG) at six months from a mean of 209.5 ± 31.23 mg/dl to 115.14 ± 36.94 mg/dl and post prandial plasma glucose (PPG) from a mean of 338.22 ± 31.76 mg/dl to 147.71 ±22.47 mg/dl (p<0.0001). Hydroxychloroquine was well tolerated throughout the study period. The mean dose of insulin glargine decreased during the study from 35.51 ± 9.93 units per day to 20.00 ± 9.6 units/day at six months (p<0.0001). The frequency of insulin glargine injections decreased from a mean of 2.15 ± 0.22/day to 1.18 ± 0.85/day (p<0.0001). In 43 (41%) patients insulin glargine had to be totally stopped. In 13 (12%) patients the dose of gliclazide decreased to 40 mg. Hydroxychloroquine was found to improve glycemic control, when given as a fourth drug (quadruple drug therapy) in addition to insulin and the combination of gliclazide and metformin in patients with type 2 DM. In a significant number of patients, insulin therapy could be stopped, and in the rest the dose of insulin and gliclazide could be reduced.
Hydroxychloroquine, Insulin, Metformin, Gliclazide, HbA1c, PPG, FPG
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Abhishek Kumar Chandra, Sajjad Ahsan, Prakash Ranjan, Ajeet Kumar Sinha, Rajeev Ranjan Kumar, Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus, International Journal of Diabetes and Endocrinology. Vol. 3, No. 4, 2018, pp. 58-62. doi: 10.11648/j.ijde.20180304.11
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