Research Article

Comparison of Efficacy and Safety of Hydroxychloroquine and Teneligliptin in Type 2 Diabetes Patients who are Inadequately Controlled with Glimepiride, Metformin and Insulin therapy: A Randomized Controlled Trial with Parallel Group Design

Prakash Ranjan, Sajjad Ahsan*, Rabi Bhushan, Bipin Kumar, Tushar, Anup Kumar Gupta, Anand Kumar Verma and Mukesh Jain

Published: 13 September, 2018 | Volume 2 - Issue 1 | Pages: 033-040

Aim: The aim of the present study is to assess the efficacy and safety of Hydroxychloroquine in comparison with Teneligliptin in type 2 diabetes patients whose blood glucose levels were inadequately controlled with metformin, Glimepiride and insulin therapy.

Methods: This was a randomized, prospective, parallel-group, experimental trial done in 300 Type 2 Diabetes patients who were uncontrolled (HbA1c=7.5–10%) with metformin, Glimepiride and insulin therapy. Patients were randomly divided into two groups one received Teneligliptin 20 mg (n=152) and other received Hydroxychloroquine 400 mg (n=148) while continuing insulin therapy with other 2 OHA. Insulin doses were adjusted to maintain normal blood glucose levels.

Result: The adjusted mean change from baseline to endpoint in HbA1c was −1.2±0.5% in patient group receiving Hydroxychloroquine and −0.9±0.5% in patients group receiving Teneligliptin, respectively, with a significant between-treatment difference (p<0.001). The incidence of adverse events was similar in the Hydroxychloroquine (72%) and Teneligliptin (77%) groups. However, hypoglycaemic events were less common (p<0.001) and less severe (p<0.05) in patients receiving Hydroxychloroquine than in those receiving Teneligliptin.

Conclusion: Hydroxychloroquine decreases HbA1c in patients whose type 2 diabetes is poorly controlled with high doses of insulin as compare to Teneligliptin. Addition of hydroxychloroquine to insulin therapy is also associated with reduced incidence of confirmed and severe hypoglycaemia.

Read Full Article HTML DOI: 10.29328/journal.acem.1001009 Cite this Article Read Full Article PDF


Hydroxychloroquine; Teneligliptin; Insulin; Type 2 Diabetes; HbA1c


  1. Nathan DM, Cleary PA, Backlund JY, Genuth SM, Lachin JM, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005; 353: 2643-2653. Ref.: https://goo.gl/tNvjBX
  2. Bergenstal RM, Johnson M, Powers MA, Wynne A, Vlajnic A, et al. Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine. Diabetes Care. 2008; 31: 1305-1310. Ref.: https://goo.gl/GTm5gb
  3. Inzucchi SE, Bergenstal RM, Buse JB, Diamant M, Ferrannini E, et al. Management of hyperglycaemia in type 2 diabetes: a patient-centered approach: position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012; 55: 1577-1596. Ref.: https://goo.gl/tUCDCC
  4. Donner T, Munoz M. Update on insulin therapy for type 2 diabetes. J Clin Endocrinol Metab. 2012; 97: 1405–1413. Ref.: https://goo.gl/sTivNH
  5. Kishimoto M. Teneligliptin: a DPP-4 inhibitor for the treatment of type 2 diabetes. Diabetes Metab Syndr Obes. 2013; 6: 187–195. Ref.: https://goo.gl/MxuEBg
  6. Tsuchimochi W, Ueno H, Yamashita E, Tsubouchi C, Sakoda H, et al. Teneligliptin improves glycemic control with the reduction of postprandial insulin requirement in Japanese diabetic patients”. Endocr J. 2015; 62: 13-20. Ref.: https://goo.gl/YPbJth
  7. Ghosh S, Trivedi S, Sanyal D, Modi KD, Kharb S. Teneligliptin real-world efficacy assessment of type 2 diabetes mellitus patients in India (TREAT- INDIA Study). Diabetes Metab Syndr Obes. 2016; 9: 347-353. Ref.: https://goo.gl/vJeUqd
  8. Scott LJ. Teneligliptin; a review in type 2 diabetes. Clin Drug Investig. 2015; 35: 765-772. Ref.: https://goo.gl/2RcsJh
  9. Kim MK, Rhee EJ, Han KA, Woo AC, Lee MK, et al. Efficacy and safety of teneligliptin: a dipeptidyl peptidase 4 inhibitor, combined with metformin in Korean patients with type 2 diabetes mellitus: a 16-week, randomized, double-blind, placebo-controlled phase III trial. Diabetes Obes Metab. 2015; 17: 309–312. Ref.: https://goo.gl/no1fnN
  10. Pareek A, Chandurkar N, Thomas N, Viswanathan V, Deshpande A, et al. Efficacy and safety of hydroxychloroquine in the treatment of type 2 diabetes mellitus: a double blind, randomized comparison with pioglitazone. 2014; 30: 1257–1266. Ref.: https://goo.gl/MKEc1g
  11. Quatraro A, Consoli G, Magno M, Caretta F, Nardozza A, et al. Hydroxychloroquine in decompensated, treatment-refractory noninsulin-dependent diabetes mellitus. a new job for an old drug? Ann Intern Med 1990; 112: 678–681. Ref.: https://goo.gl/1NE9ET
  12. Baidya A, Chakravarti HN, Saraogi RK, Gupta A, Ahmed R, et al. Efficacy of Maximum and Optimum Doses of Hydroxychloroquine Added to Patients With Poorly Controlled Type 2 Diabetes on Stable Insulin Therapy along with Glimepiride And Metformin: Association of High-Sensitive C-Reactive Protein (Hs-CRP) and Glycosylated Haemoglobin (HbA1c). Endocrinol Metab Syndr. 2018; 7: 283. Ref.: https://goo.gl/UL29JC
  13. Jagnani VK, Bhattacharya NR, Satpathy SC, Hasda GC, Chakraborty S. Effect of Hydroxychloroquine on Type 2 Diabetes Mellitus Unresponsive to More Than Two Oral Antidiabetic Agents. J Diabetes Metab. 2017; 8: 771. Ref.: https://goo.gl/e6LbQG
  14. Baidya A, Kumar M, Pathak SK, Ahmed R. Study of comparative effect of hydroxychloroquine and vildagliptin on glycaemic efficacy and HbA1c in type 2 diabetes patients who were inadequately controlled with metformin and glimepiride dual therapy; JMSCR. 2018; 6: 409-415. Ref.: https://goo.gl/qmhJhd
  15. Sing SP, Sinha MK, Alok KA, Ranjan R. Comparative Study to Evaluate Effect of Hydroxychloroquine Versus Sitagliptin as Add on Therapy in Patients with Type 2 Diabetes Inadequately Controlled on Combination with Metformin and Gliclazide: A Multicenter, Observational Trial. Sch J App Med Sci. 2018; 6: 2150-2156
  16. Meneilly GS, Elliott T, Tessier D, Hards L, Tildsesley H. NIDDM in the elderly. Diabetes Care. 1996; 19: 1320–1325. Ref.: https://goo.gl/Zt5YQ8
  17. Yang SH, Dou KF, Song WJ. Prevalence of diabetes among men and women in China. N Engl J Med. 2010; 362: 2425–2426. https://goo.gl/fbvMDf
  18. Nathan DM, Buse JB, Davidson MB, Heine RJ, Holman RR, et al. Management of hyperglycaemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy. A consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia. 2006; 49: 1711–1721. Ref.: https://goo.gl/SpbEMH
  19. Hepburn DA, MacLeod KM, Pell AC, Scougal IJ, Frier BM. Frequency and symptoms of hypoglycaemia experienced by patients with type 2 diabetes treated with insulin. Diabet Med. 1993; 10: 231–237. Ref.: https://goo.gl/yuE9gT


Figure 1

Figure 1

Figure 1

Figure 2

Similar Articles

Recently Viewed

  • Neurotoxicity related exposure to ambient nanoparticles
    Mojtaba Ehsanifar*, Zeinab Montazeri and Mehravar Rafati Mojtaba Ehsanifar*,Zeinab Montazeri,Mehravar Rafati. Neurotoxicity related exposure to ambient nanoparticles. J Neurosci Neurol Disord. 2022: doi: 10.29328/journal.jnnd.1001060; 6: 005-010
  • Pediatric brainstem glioma
    Ghita Hatim*, Tarik Chekrine, Majdouline Houjami, Mouna Boughafour, Zineb Bouchbika, Nadia Benchakroun, Hassan Jouhadi, Nezha Tawfiq, Abdelatif Benider and Souha Sahraoui Ghita Hatim*,Tarik Chekrine,Majdouline Houjami,Mouna Boughafour,Zineb Bouchbika,Nadia Benchakroun,Hassan Jouhadi,Nezha Tawfiq,Abdelatif Benider,Souha Sahraoui. Pediatric brainstem glioma. J Neurosci Neurol Disord. 2022: doi: 10.29328/journal.jnnd.1001059; 6: 001-004
  • SGLT2 Inhibitors and nephroprotection in diabetic kidney disease: From mechanisms of action to the latest evidence in the literature
    Jorge Rico-Fontalvo, Rodrigo Daza-Arnedo, Maria Ximena Cardona-Blanco, Victor Leal-Martínez, Emilio Abuabara-Franco, Nehomar Pajaro-Galvis*, Jose Cabrales, José Correa, Manuel Cueto, Amable Duran, Alejandro Castellanos, Javier Enamorado, José Bohórquez, Isabella Uparella, Julio Zuñiga, Abraham Chagui, Alfonso Ramos and Luis Lara Jorge Rico-Fontalvo,Rodrigo Daza-Arnedo,Maria Ximena Cardona-Blanco,Victor Leal-Martínez,Emilio Abuabara-Franco,Nehomar Pajaro-Galvis*,Jose Cabrales,José Correa,Manuel Cueto,Amable Duran,Alejandro Castellanos,Javier Enamorado,José Bohórquez,Isabella Uparella,Julio Zuñiga,Abraham Chagui,Alfonso Ramos,Luis Lara. SGLT2 Inhibitors and nephroprotection in diabetic kidney disease: From mechanisms of action to the latest evidence in the literature. J Clini Nephrol. 2020: doi: 10.29328/journal.jcn.1001058; 4: 044-055
  • Neurosciences and dynamical system theory: some short remarks
    Giuseppe Iurato* Giuseppe Iurato*. Neurosciences and dynamical system theory: some short remarks. J Neurosci Neurol Disord. 2021: doi: 10.29328/journal.jnnd.1001058; 5: 094-095
  • Intrasellar psammomatous meningioma: a case report and review of the literature
    Luca Riccioni*, Antonio Balestrieri, Fuschillo Dalila, Maria Teresa Nasi and Luigino Tosatto Luca Riccioni*,Antonio Balestrieri,Fuschillo Dalila,Maria Teresa Nasi,Luigino Tosatto. Intrasellar psammomatous meningioma: a case report and review of the literature. J Neurosci Neurol Disord. 2022: doi: 10.29328/journal.jnnd.1001061; 6: 011-015

Read More

Most Viewed

Read More