Rajput Rajesh, Saini Suyasha, Rajput Siddhant, Upadhyay Parankush
Department of Endocrinology and Medicine, Unit IV, Pt. B.D.S. PGIMS, Rohtak, Haryana, India.
Indian J Endocrinol Metab. 2022 Nov-Dec;26(6):537-542. doi: 10.4103/ijem.ijem_350_22. Epub 2023 Feb 7.
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.
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.
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).
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.
迄今为止，尚无研究评估羟氯喹对血糖变异性各项参数的影响。旨在评估羟氯喹对接受格列美脲和二甲双胍治疗但血糖控制不佳的2型糖尿病患者血糖变异性的影响。
在为期12周的研究期间，共30例年龄在18 - 65岁、接受格列美脲和二甲双胍治疗但血糖控制不佳（糖化血红蛋白7.5 - 10%[58 - 86 mmol/mol]）的2型糖尿病患者，加用400 mg羟氯喹。通过连续血糖监测系统（CGMS）数据，在基线及加用400 mg羟氯喹12周后，评估血糖变异性参数，如24小时血糖标准差、每日差异均值（MODD）和血糖波动幅度均值（MAGE）。通过比较加用400 mg羟氯喹后第12周与基线时的空腹、餐后血糖及糖化血红蛋白变化来评估疗效。
加用羟氯喹辅助治疗12周后，血糖变异性的所有参数，包括MAGE、MODD、24小时血糖标准差和平均血糖均显著降低，空腹、餐后血糖及糖化血红蛋白也显著降低。在加用羟氯喹辅助治疗12周结束时，血糖在目标范围3.9 - 8.3 mmol/L（70 - 150 mg/dL）的时间百分比有显著改善。
在血糖控制不佳的糖尿病患者中加用羟氯喹可显著降低所有血糖参数，包括血糖变异性的所有参数，因此对于接受格列美脲和二甲双胍治疗但血糖控制不佳的患者而言，它可能是一种有效的附加治疗药物。
