A Patient with Uncontrolled Type 2 Diabetes and Dyslipidemia whose Blood Glucose Level is managed by Hydroxychloroquine 400 mg: A Case Report

Inflammation is considered to play a crucial intermediary role in pathogenesis of diabetes and number of co-existing disease. Hydroxychloroquine (HCQ) works through a novel mechanism and may therefore be a useful adjunctive therapy for patients with T2DM. Here I report a case of a female patient with uncontrolled type 2 diabetes with dyslipidemia who achieve an optimal glycemic control when Hydroxychloroquine was added to the existing pharmacotherapy. The subject has been taking Metformin (500 mg), Glimepiride (2 mg), Voglibose (0.2 mg) and Vildagliptin (500 mg) and a strict exercise regimen for last 2 year but his diabetes was poorly controlled with glycated haemoglobin (HbA1c) of 8.3%. Patient expresses anxiety about using injectable therapy and refused initiation of basal insulin. To achieve glycemic control HCQ 400 mg once daily was initiated as an add on antidiabetic drug. After 12 weeks, her fasting blood glucose was 135 mg/dL, and postprandial glucose was 190 mg/dL and HbA1c was 7.4%. She returns for follow-up after 24 weeks and is feeling well. She states that her quality of life has improved significantly. After 24 weeks, her fasting blood glucose was 115 mg/dL, postprandial glucose was 150 mg/dL and her HbA1c was 6.8%. The case highlights that Hydroxychloroquine 400 mg once a day is an effective add-on for getting good glycemic control when appropriately used in type 2 diabetes mellitus patients who are poorly controlled on other oral agents.