Shojania K, Koehler B E, Elliott T
Department of Medicine, University of British Columbia, Vancouver, Canada.
J Rheumatol. 1999 Jan;26(1):195-6.
A 77-year-old man with type II diabetes taking a stable dose of subcutaneous, twice daily human insulin developed symmetrical, inflammatory, rheumatoid factor positive polyarthritis. Within 2 weeks of starting therapy with prednisone 5 mg daily and hydroxychloroquine 400 mg daily he had 2 episodes of severe hypoglycemic coma requiring emergency care. His blood glucose became controlled again when his insulin was decreased by 37%. There are no reported cases of hypoglycemia in diabetic or nondiabetic patients treated with hydroxychloroquine. Hydroxychloroquine has been reported to reduce insulin requirements in refractory type II diabetes by an average of 30%. When hydroxychloroquine is initiated for the treatment of polyarthritis in a type II diabetic requiring insulin or sulfonylurea treatment, blood glucose levels should be monitored closely and the insulin dose may need to be reduced.
一名77岁的2型糖尿病男性，稳定皮下注射每日两次的人胰岛素，出现了对称性、炎症性、类风湿因子阳性的多关节炎。在开始每日服用5毫克泼尼松和每日服用400毫克羟氯喹治疗的2周内，他发生了2次严重低血糖昏迷，需要紧急护理。当他的胰岛素减少37%时，他的血糖再次得到控制。在接受羟氯喹治疗的糖尿病或非糖尿病患者中，未报告过低血糖病例。据报道，羟氯喹可使难治性2型糖尿病患者的胰岛素需求量平均降低30%。当在需要胰岛素或磺脲类治疗的2型糖尿病患者中开始使用羟氯喹治疗多关节炎时，应密切监测血糖水平，可能需要减少胰岛素剂量。
