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Research Article
Volume 3 Issue 4 - 2018
Comparison between the Clinical Efficacy and Safety of Hydroxychloroquine and Sitagliptin Added to Inadequately Controlled with Glimepiride and Metformin in Indian Patients with Type 2 Diabetes Mellitus: A Real World Observational Study
UP Singh1, Swapnil Jain2, Manikant Singla3, Nishesh Jain4, Rishad Ahmed5*, Amit Gupta6 and KP Lal7
1Diabetologist, MAU Banaras Hindu University, Varanasi, Uttar Pradesh, India
2Endocrinologist, Columbia Asia Hospital, Ghaziabad, Uttar Pradesh, India
3Endocrinologist, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
4Endocrinologist, Guru Teg Bahadur Hospital, New Delhi, India
5Associate Professor, Department of Medicine, KPC Medical College and Hospital, Kolkata, West Bengal, India
6Diabetologist, GD Hospital and Diabetes Institute, Kolkata, West Bengal, India
7Diabetologist, Lal Diabetes Clinic, Patna, Bihar, India
*Corresponding Author: Rishad Ahmed, Associate Professor, Department of Medicine, KPC Medical College and Hospital, Kolkata, West Bengal, India.
Received: July 17, 2018; Published: August 21, 2018
Citation: Rishad Ahmed., et al. “Comparison between the Clinical Efficacy and Safety of Hydroxychloroquine and Sitagliptin Added to Inadequately Controlled with Glimepiride and Metformin in Indian Patients with Type 2 Diabetes Mellitus: A Real World Observational Study". EC Endocrinology and Metabolic Research 3.4 (2018): 147-155.
Aim: The present study was aimed to compare the clinical efficacy and safety of Hydroxychloroquine and sitagliptin added to inadequately control with Glimepiride and Metformin in Indian type 2 diabetes mellitus (T2DM) patients.
Methods: This is an observational trial done at various diabetic care units of India in 600 inadequately controlled T2DM patients with Glimepiride and Metformin. All patients were randomly allotted into two groups, in one group 320 patients were started with Hydroxychloroquine 400 mg/day along with metformin 1000 mg/day and Glimepiride 2 mg/day. In other group 320 patients were started with Sitagliptin 100 mg/day while continuing with metformin 1000 mg/day and Glimepiride 2 mg/day. After 24 week 300 patient’s data in each group were available for analysis. Changes from baseline in HbA1c, 2-hour PPG and FPG levels, serum creatinine, lipid profile (triglyceride, total cholesterol, LDL- cholesterol and HDL-cholesterol), inflammatory markers (hs-CRP) and fasting insulin level after 24 weeks of treatment were calculated.
Result: There was almost 1.4% reduction in HbA1c in hydroxychloroquine group after 24 week from baseline which was 1.2% with sitagliptin group (p < 0.01). Fasting Blood Glucose (FBG) was significantly reduced in Hydroxychloroquine group than sitagliptin group (-29.5 ± 10.2 vs -26.7 ± 10.8, p < 0.01) and the same effect was also shown in Post Prandial Blood Glucose (PPBG) reduction in both the groups (-92.6 ± 21.2 vs -78.7 ± 23.1, p < 0.01). Both QUICKI and HOMA-IR were significantly changed in both Hydroxychloroquine and sitagliptin group after 24 weeks. No marked changes in renal function for eGFR and creatinine levels were found in patients in the two groups. Plasma hs-CRP at week 24 declined more in the Hydroxychloroquine group than the Sitagliptin group (P < 0.001) from baseline. There was more favourable reduction in triglyceride, total cholesterol, LDL- cholesterol and significant increase in HDL-C with hydroxychloroquine group than sitagliptin group..
Conclusion: Hydroxychloroquine decreased the levels of insulin, TG and LDL-C in subjects with type 2 diabetes mellitus with a significant effect on FPG, PPG and HbA1c. Moreover, insulin sensitivity, as a major factor of chronic complications of type 2 diabetes, significantly improved with Hydroxychloroquine in the present study as compare to patients receiving Sitagliptin. This observational trial had proved that Hydroxychloroquine can be a therapeutic alternative of highly priced Sitagliptin in Indian type 2 diabetes patients..
Keywords: Blood Glucose; Diabetes; Hydroxychloroquine; Sitagliptin; Insulin Sensitivity; hs-CRP
Copyright: © 2018 Rishad Ahmed., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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