The effect of hydroxychloroquine on glucose control and insulin resistance in the prediabetes condition


Isfahan Endocrine and Metabolic Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: Hydroxychloroquine can improve most underlying coronary risk factors; however, there are a few studies on the effects of hydroxychloroquine on blood glucose and insulin resistance. The current study aimed to assess the effects of hydroxychloroquine on blood glucose control status as well as on level of lipid profile and inflammatory biomarkers in prediabetic patients.
Materials and Methods: In a randomized, double-blinded, controlled trial, 39 consecutive patients who were suffering from prediabetes and were referred to the Isfahan Endocrinology Center in January 2013 were randomly assigned to receive hydroxychloroquine (6.5 mg/kg/day) (n = 20) or placebo (n = 19) for 12 weeks. The biomarker indices and anthropometric parameters were tested before and after completion of treatment.
Results: In both groups of patients receiving hydroxychloroquine and placebo, except for serum level of insulin that was significantly elevated after treatment by hydroxychloroquine, the changes in other parameters remained insignificant. Both groups experienced increase of insulin level, but this change was considerably higher in those groups receiving hydroxychloroquine. The group receiving hydroxychloroquine experienced reduction of glucose at 60 min of Oral Glucose Tolerance Test (OGTT) test after intervention, while the placebo group experienced increase of blood glucose at the same time.
Conclusion: The use of hydroxychloroquine may increase the serum insulin level in patients with prediabetic states who are at risk of developing diabetes mellitus.


Haffner SM. Pre-diabetes, insulin resistance and CVD risk. Diabetic Res Clin Pract 2003;61:S9-18.  Back to cited text no. 1
Bock G, Dallamana C, Campioni M, Chittilepilly E, Basu R, Toffolo G, et al. Pathogenesis of Pre- Diabetes (Mechanisms of Fasting and post prandial hyperglycemia in people with impaired fasting glucose and/or impaired glucose Tolerance: Diabetes 2006;55:3536-49.  Back to cited text no. 2
Osei K, Galland T, hinsmith S. Impaired Insulin Sensivity, Insulin Secretion, and Glucose Effectivness Perdic Future Develipment of Impaired Glucose and Glucose Tolerance and type 2 diabetes in pre-diabetic African – Americans. Diabet Care 2004;27:1439-46.  Back to cited text no. 3
Gerstein HC, Thorpe KE, Taylon DW, Haynes RB. The effectiveness of hydroxychloroquine in patients with type 2 diabetes mellitus who are refractory to sulfonylureas – A randomized trial. Diabetes Res Clin Pract 2002;55:209-19.  Back to cited text no. 4
Emami J, Gerstein HC, Pasutto FM, Jamali F. Insulin – Sparing effect of hydroxychloroquine in diabetic rats is concentration dependent. Can J Physiol Pharmacol 1999;77:118-23.  Back to cited text no. 5
Wasko MC, Hubert HB, Lingala VB, Elliott JR, Luggen ME, Fries JF, et al. Hydroxychloroquine and risk of diabetes in patients with rheumatoid arthritis. JAMA 2007;298:187-93.  Back to cited text no. 6
Qatraro A, Consoli G, Magno M, Caretta F, Nardozz A, Ceriello A. Hydroxychloroquin in decompensated treatment – Refractory non insuli – Dependent diabetes mellitus, A new job for an old drug?. Ann Intern Med 1990:112:628-81.  Back to cited text no. 7
Petri M, Lakatta C, Magder L, Goldman D. Effect of prednisone and hydroxychloroquine on coronary artery disease risk factors in systemic lupus erythematosus: A longitudinal data analysis. Am J Med 1994;96:254-9.  Back to cited text no. 8
Morris SJ, Wasko MC, Antohe JL, Sartorius JA, Kirchner HL, Dancea S, et al. Hydroxychloroquine use associated with improvement in lipid profiles in rheumatoid arthritis patients. Arthritis Care Res (Hoboken) 2011;63:530-4.  Back to cited text no. 9
Penn SK, Kao AH, Schott LL, Elliott JR, Toledo FG, Kuller L, et al. Hydroxychloroquine and glycemia in women with rheumatoid arthritis and systemic lupus erythematosus. J Rheumatol 2010;37:1136-42.  Back to cited text no. 10
Solomon DH, Massarotti E, Garg R, Liu J, Canning C, Schneeweiss S. Association between disease-modifying antirheumatic drugs and diabetes risk in patients with rheumatoid arthritis and psoriasis. JAMA 2011;305:2525-31.  Back to cited text no. 11
Emami J, Gerstein HC, Pasutto FM, Jamali F. Insulin-sparing effect of hydroxychloroquine in diabetic rats is concentration dependent. Can J Physiol Pharmacol 1999;77:118-23.  Back to cited text no. 12
Garcia-Webb P, Bonser AM. Insulin binding and degradation in isolated hepatocytes from streptozotocin injected rats. Biochem Biophys Res Commun 1985;128:487-93.  Back to cited text no. 13
Quatraro A, Consoli G, Magno M, Caretta F, Nardozza A, Ceriello A, et al. Hydroxychloroquine in decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. A new job for an old drug? Ann Intern Med 1990;112:678-81.  Back to cited text no. 14
Rho YH, Oeser A, Chung CP, Milne GL, Stein CM. Drugs Used in the Treatment of Rheumatoid Arthritis: Relationship between current use and Cardiovascular Risk Factors. Arch Drug Inf 2009;2:34-40.  Back to cited text no. 15
Costedoat-Chalumeau N, Hulot JS, Amoura Z, Delcourt A, Maisonobe T, Dorent R, et al. Cardiomyopathy related to antimalarial therapy with illustrative case report. Cardiology 2007;107:73-80.  Back to cited text no. 16
Costedoat-Chalumeau N, H ulot JS, Amoura Z, Leroux G, Lechat P, Funck-Brentano C, et al. Heart conduction disorders related to antimalarials toxicity: An analysis of electrocardiograms in 85 patients treated with hydroxychloroquine for connective tissue diseases. Rheumatology (Oxford) 2007;46:808-10.  Back to cited text no. 17
Nauck MA, Sauerwald A, Ritzel R, Holst JJ, Schmiegel W. Influence of glucagon-like peptide 1 on fasting glycemia in type 2 diabetic patients treated with insulin after sulfonylurea secondary failure. Diabetes Care 1998;21:1925-31.  Back to cited text no. 18
Drucker DJ. Glucagon-like peptides. Diabetes 1998;47:159-69.  Back to cited text no. 19
Rekedal LR, Massarotti E, Garg R, Bhatia R, Gleeson T, Lu B, et al. Changes in glycosylated hemoglobin after initiation of hydroxychloroquine or methotrexate treatment in diabetes patients with rheumatic diseases. Arthritis Rheum 2010;62:3569-73.  Back to cited text no. 20