Effect of Hydroxychloroquine on Glycemic Variability in Type 2 Diabetes Patients Uncontrolled on Glimepiride and Metformin Therapy.

ABSTRACT

Background and Aims: No study to date has assessed the effect of hydroxychloroquine on various parameters of glycaemic variability. To assess the effect of hydroxychloroquine on glycaemic variability in type 2 diabetes patients uncontrolled on glimepiride and metformin. Methods: A total of 30 T2DM patients aged 18-65 years uncontrolled on glimepiride and metformin therapy with HbA1c 7.5-10% (58-86 mmol/mol) were given adjunctive hydroxychloroquine 400 mg during the 12-week study period. The glycaemic variability parameters such as standard deviation of 24 hours of blood glucose, mean of daily differences (MODD) and mean amplitude of glycaemic excursion (MAGE) were assessed by continuous glucose monitoring system (CGMS) data at baseline and at 12 weeks after the addition of hydroxychloroquine 400 mg. Efficacy was assessed by change in fasting, postprandial plasma glucose and HbA1c from baseline to 12 weeks of addition of 400 mg hydroxychloroquine. Results: There was a significant reduction in all parameters of glycaemic variability including MAGE, MODD, standard deviation of 24-hour blood glucose and average blood glucose as well as a significant reduction in fasting, postprandial blood glucose and glycated haemoglobin post 12 weeks of adjunctive treatment with hydroxychloroquine. At the end of 12 weeks of adjunctive treatment with hydroxychloroquine, there was a significant improvement in the percentage of time spent in the target glucose range of 3.9-8.3 mmol/L (70-150 mg/dL). Conclusion: The addition of hydroxychloroquine in uncontrolled diabetes significantly reduces all glycaemic parameters including all parameters of glycaemic variability and hence can be an effective add-on to patients uncontrolled on glimepiride and metformin therapy.