Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus

Abhishek Kumar Chandra; Sajjad Ahsan; Prakash Ranjan; Ajeet Kumar Sinha; Rajeev Ranjan Kumar

doi:doi:10.11648/j.ijde.20180304.11

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Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus

Abhishek Kumar Chandra, Sajjad Ahsan, Prakash Ranjan, Ajeet Kumar Sinha, Rajeev Ranjan Kumar

Published in International Journal of Diabetes and Endocrinology (Volume 3, Issue 4)

Received: 25 November 2018 Accepted: 11 December 2018 Published: 7 January 2019

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Abstract

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.

Published in	International Journal of Diabetes and Endocrinology (Volume 3, Issue 4)
DOI	10.11648/j.ijde.20180304.11
Page(s)	58-62
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Hydroxychloroquine, Insulin, Metformin, Gliclazide, HbA1c, PPG, FPG

References

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[10]	Yki-Jarvinen H, Ryysy L, Nikkila K, Tulokas T, Vanamo R, Heikkila M. Comparison of bedtime insulin regimens in patients with type 2 diabetes mellitus: a randomized, controlled trial. Ann Intern Med 1999; 130: 389-96.
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[15]	Pareek A., et al. “Efficacy and safety of hydroxychloroquine in the treatment of type 2 diabetes mellitus: a double blind, randomized comparison with pioglitazone”. Current Medical Research and Opinion 30.7 (2014): 1257-1266.
[16]	Jagnani VK, Bhattacharya NR, Satpathy SC, Hasda GC, Chakraborty S. Effect of hydroxychloroquine on type 2 diabetes mellitus unresponsive to more than two oral antidiabetic agents. J Diabetes Metab. 2017; 8: 771.
[17]	Baidya A, Chakravarti HN, Saraogi RK, Gupta A, Ahmed R, et al. Efficacy of maximum and optimum doses of hydroxychloroquine added to patients with poorly controlled type 2 diabetes on stable insulin therapy along with glimepiride and metformin: association of high-sensitive c-reactive protein (hs-crp) and glycosylated haemoglobin (hba1c). Endocrinol Metab Syndr. 2018; 7: 283-7.
[18]	Kumar V, Singh MP, Singh AP, Pandey MS, Kumar S, Kumar S. Efficacy and safety of Hydroxychloroquine when added to stable insulin therapy in combination with metformin and glimepiride in patients with type 2 diabetes compare to sitagliptin. Int J Basic Clin Pharmacol 2018; 7.
[19]	Ranjan P, Ahsan S, Bhushan R, Kumar B, Tushar, et al. Comparison of Effi cacy and Safety of Hydroxychloroquine and Teneligliptin in Type 2 Diabetes Patients who are Inadequately Controlled with Glimepiride, Metformin and Insulin therapy: A Randomized Controlled Trial with Parallel Group Design. Ann Clin Endocrinol Metabol. 2018; 2: 030-040. https://doi.org/10.29328/journal.acem.1001009

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Abhishek Kumar Chandra, Sajjad Ahsan, Prakash Ranjan, Ajeet Kumar Sinha, Rajeev Ranjan Kumar. (2019). 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, 3(4), 58-62. https://doi.org/10.11648/j.ijde.20180304.11

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ACS Style

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. Int. J. Diabetes Endocrinol. 2019, 3(4), 58-62. doi: 10.11648/j.ijde.20180304.11

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AMA Style

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. Int J Diabetes Endocrinol. 2019;3(4):58-62. doi: 10.11648/j.ijde.20180304.11

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@article{10.11648/j.ijde.20180304.11,
  author = {Abhishek Kumar Chandra and Sajjad Ahsan and Prakash Ranjan and Ajeet Kumar Sinha and Rajeev Ranjan Kumar},
  title = {Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {3},
  number = {4},
  pages = {58-62},
  doi = {10.11648/j.ijde.20180304.11},
  url = {https://doi.org/10.11648/j.ijde.20180304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20180304.11},
  abstract = {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.},
 year = {2019}
}

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TY  - JOUR
T1  - Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus
AU  - Abhishek Kumar Chandra
AU  - Sajjad Ahsan
AU  - Prakash Ranjan
AU  - Ajeet Kumar Sinha
AU  - Rajeev Ranjan Kumar
Y1  - 2019/01/07
PY  - 2019
N1  - https://doi.org/10.11648/j.ijde.20180304.11
DO  - 10.11648/j.ijde.20180304.11
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 58
EP  - 62
PB  - Science Publishing Group
SN  - 2640-1371
UR  - https://doi.org/10.11648/j.ijde.20180304.11
AB  - 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.
VL  - 3
IS  - 4
ER  -

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Author Information

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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APA Style

Abhishek Kumar Chandra, Sajjad Ahsan, Prakash Ranjan, Ajeet Kumar Sinha, Rajeev Ranjan Kumar. (2019). 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, 3(4), 58-62. https://doi.org/10.11648/j.ijde.20180304.11

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ACS Style

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. Int. J. Diabetes Endocrinol. 2019, 3(4), 58-62. doi: 10.11648/j.ijde.20180304.11

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AMA Style

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. Int J Diabetes Endocrinol. 2019;3(4):58-62. doi: 10.11648/j.ijde.20180304.11

Copy | Download

@article{10.11648/j.ijde.20180304.11,
  author = {Abhishek Kumar Chandra and Sajjad Ahsan and Prakash Ranjan and Ajeet Kumar Sinha and Rajeev Ranjan Kumar},
  title = {Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus},
  journal = {International Journal of Diabetes and Endocrinology},
  volume = {3},
  number = {4},
  pages = {58-62},
  doi = {10.11648/j.ijde.20180304.11},
  url = {https://doi.org/10.11648/j.ijde.20180304.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijde.20180304.11},
  abstract = {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.},
 year = {2019}
}

Copy | Download

TY  - JOUR
T1  - Efficacy of Hydroxychloroquine as an Add on Drug with Basal Insulin, Gliclazide and Metformin in Subjects with Uncontrolled Type 2 Diabetes Mellitus
AU  - Abhishek Kumar Chandra
AU  - Sajjad Ahsan
AU  - Prakash Ranjan
AU  - Ajeet Kumar Sinha
AU  - Rajeev Ranjan Kumar
Y1  - 2019/01/07
PY  - 2019
N1  - https://doi.org/10.11648/j.ijde.20180304.11
DO  - 10.11648/j.ijde.20180304.11
T2  - International Journal of Diabetes and Endocrinology
JF  - International Journal of Diabetes and Endocrinology
JO  - International Journal of Diabetes and Endocrinology
SP  - 58
EP  - 62
PB  - Science Publishing Group
SN  - 2640-1371
UR  - https://doi.org/10.11648/j.ijde.20180304.11
AB  - 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.
VL  - 3
IS  - 4
ER  -

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