DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20182933

Effect of early addition of hydroxychloroquine in type 2 diabetic patients inadequately controlled on metformin and sulfonylurea combination therapy

Arjun Baidya, Rishad Ahmed

Abstract


Background: Present study assessed the effect of early addition of hydroxychloroquine to metformin and sulfonylurea in inadequately controlled T2DM patients as compared to up titration of the metformin or sulfonylurea (glimepiride) doses.

Methods: Patients with glycated haemoglobin (HbA1c) between ≥7.0 to ≤9.0% and on metformin 1000mg/day and glimepiride 2mg/day for at least 12 weeks were analysed for this study. Patients were randomized into three groups, in one group (n=55) metformin dose was up titrated to 2000mg daily and in second group (n=55) hydroxychloroquine (HCQ) 400mg was added along with other and in third group (n=55) glimepiride dose was up titrated to 4mg. Fasting plasma glucose (FPG), post prandial plasma glucose (PPG) and glycated haemoglobin (HbA1c) were measured at baseline and after 12 and 24 weeks. Low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and Triglyceride were measured at baseline and after 6 months. Authors have analysed the data of 150 patients as rest were either lost in follow up or discontinue therapy.

Results: After 24 weeks, the mean HbA1c was 6.5% in hydroxychloroquine group (p<0.001) versus 6.8% in metformin 2000mg group (p<0.001) and 6.7% in glimepiride 4mg group (p<0.001). There was also a modest reduction in lipid parameters (p<0.001) with no change in serum creatinine level and a marginal reduction in body weight in the HCQ group. Incidence of confirmed hypoglycemia was significantly lower in patients of HCQ group compared to glimepiride group in this study.

Conclusions: Hydroxychloroquine as add on to metformin and glimepiride combination during the early course of treatment helps in achieving glycaemic target and can consider as an option rather up titrating the dose of metformin or glimepiride.


Keywords


Fasting plasma glucose, Glimepiride, Hydroxychloroquine, Metformin, Post prandial plasma glucose, T2DM

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