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Rheumatoid arthritis drug helps cut type 2 diabetes mellitus risk

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By David Liu, PHD

Saturday Dec 31, 2011 (foodconsumer.org) -- Using hydroxychloroquine may help patients with Rheumatoid arthritis to reduce their risk for type 2 diabetes mellitus, according to a new study in the April 2011 issue of Journal of Clinical Rheumatology.

Hydroxychloroquine is an antimalarial drug, sold under the trade names Plaquenil, Axemal (in India), Dolquine, and Quensyl, and it is also used to treat rheumatoid arthritis and lupus and reduce inflammation in the patients.

Some small studies have associated hydroxychloroquine use with decreased risk for type 2 diabetes mellitus or improved glycemic control in patients with rheumatoid arthritis, according to the background information in the report authored by Androniki Bili MD, MPH and colleagues at Geisinger Health System in Danville, PA.

The current study found rheumatoid arthritis patients using hydroxychloroquine for a median duration of 14 months had incidence rates of 6.2 cases of diabetes per 1000 patients per year, compared to 22.0 per 1000 patients per year who did not use the drug.

The current study considered a bigger retrospective cohort of 1127 adults with newly diagnosed rheutamoid arthritis who did not have type 2 diabetes mellitus at baseline and sought medical attention within the Geisinger Health System from Jan 1 2003 through March 31, 2008. The ever and never hydroxychloroquine users were 26.0 and 23.0 months, respectively.

After adjusting for other factors including sex, age, body mass index, positive rheumatoid factor and anti-cyclic citrullinated peptide antibodies, erythrocyte sedimentation rate, and nonsteroidal anti-inflammatory drug, glucocorticoid, methotrexate, and tumor necrosis factor α inhibitor use, the researchers found hydroxychloroquine users were 71 percent less likely to be diagnosed with type 2 diabetes mellitus than those who did not use the medication.

Like many other drugs, prolonged use of hydroxychloroquine to treat lupus and arthritis can cause lots of side effects including altered eye pigmentation, acne, anemia, bleaching of hair, blisters in mouth and eyes, blood disorders, convulsions, significant vision difficulties, diminished reflexes, emotional changes, excessive coloring of the skin, hearing loss, hives, itching, liver problems or failure, loss of hair, muscle paralysis, weakness or atrophy, nightmares, psoriasis, reading difficulties, tinnitus, skin inflammation and scaling, skin rash, vertigo, and weight loss.  

In addition, the drug when used for a short term to treat malaria can cause acute symptoms including abdominal cramps, diarrhea, heart problems, reduced appetite, headache, nausea and vomiting.

Type 2 diabetes mellitus affects about 26 million Americans, according to the Centers for Disease Control and Prevention. The disease can eventually lead to serious complications and completely disable patients.  The disease is preventable.  A healthy diet and lifestyle can help prevent the disease.

Foodconsumer.org has extensively published studies that suggest what may reduce the risk or help diabetes patients and what may increase risk of type 2 diabetes mellitus.

Observational studies suggest the following may help cut the risk of type 2 diabetes mellitus: Weight loss, physical activity, vitamin D, eating fish and shellfish, dairy products, breastfeeding, Mediterranean diet, green leafy vegetables, high vitamin C, calcium, soy products (better than drugs), coffee, teas, plant-based diet, vegetarian diet, vegan diet, wheat bran, Psyllium fiber supplements, n-3 polyunsaturated fatty acids, brown rice, L-carnitine, vitamin k, selenium, garlic, turmeric, and safflower oil among other things. 

Studies also suggest the following may boost the risk of type 2 diabetes mellitus:  Night shift work, dietary intake of fructose from high fructose corn syrup and other foods, processed red meat, flame retardants found in household products, sugar-sweetened drinks, depression, physical inactivity, inhaled steroids, HIV drugs, low serum potassium, fruit juice, fatty foods, smoking, statins, radiation, inflammation, exposure to pesticides, obesity, insufficient sleep or too much sleep, bisphenol A in plastic, and pollutants in fish among others. 

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