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Hydroxychloroquine in Decompensated, Treatment-Refractory Noninsulin-Dependent Diabetes Mellitus: A New Job for an Old Drug?

Antonio Quatraro, MD; Giuseppe Consoli, MD; Mauro Magno, MD; Francesco Caretta, MD; Alberto Nardozza, MD; Antonio Ceriello, MD; and Dario Giugliano, MD
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Requests for Reprints: Dario Giugliano, MD, Cattedra di Diabetologia e Dietoterapia, I °Policlinico Universitario, Piazza L. Miraglia, 2, 80138 Napoli, Italy.

Current Author Addresses: Drs. Quatraro, Consoli, Magno, Caretta, and Nardozza: Casa di Cura S. Rita, Taranto, Italy.

Drs. Ceriello and Giugliano: Cattedra di Diabetologia e Dietoterapia, I ° Policlinico Universitario, Piazza L. Miraglia, 2, 80138, Napoli, Italy.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;112(9):678-681. doi:10.7326/0003-4819-112-9-678
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Study Objective: To evaluate the usefulness and safety of hydroxychloroquine in patients with decompensated, treatment-refractory noninsulin-dependent diabetes mellitus.

Design: Prospective, randomized, placebo, double-blind 6-month trial.

Patients: Thirty-eight patients with noninsulin-dependent diabetes resistant to commonly used therapies (oral drugs, insulin, combination of insulin and oral drugs).

Interventions: Two study groups: one received insulin (n = 22) and the other, glibenclamide (n = 16). In each group, half of the patients were randomly allocated into two subgroups who continued the previous treatment but took either placebo tablets or hydroxychloroquine, 200 mg three times a day. The four subgroups were as follows: insulin and placebo (n = 11); insulin and hydroxychloroquine (n = 11); glibenclamide and placebo (n = 8); and glibenclamide and hydroxychloroquine (n = 8).

Measurements and Main Results: At 6 months, relevant and statistically significant improvement occurred in the 11 patients who received the insulin and hydroxychloroquine (glucose profile decrease, -11.7 mmol/L; 95% CI, -13.9 to -9.5, P = 0.001; glycated hemoglobin A1c decrease, -3.3%; 95% CI, -3.9 to -2.7, P = 0.001). No significant changes were seen in patients on placebo. The daily insulin dose in patients treated with the combined insulin and hydroxychloroquine therapy had to be reduced an average of 30%. No important side effects were detected.

Conclusions: 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.


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