Hydroxychloroquine vs Teneligliptin in Uncontrolled Type 2 Diabetes A Randomized Trial

Introduction

Managing Type 2 diabetes mellitus (T2DM) becomes increasingly complex when patients remain inadequately controlled despite combination therapy with metformin, glimepiride, and insulin. Identifying effective add-on therapies that improve glycemic control while minimizing hypoglycemia is a growing clinical priority.

Recent clinical research highlights the comparative role of hydroxychloroquine and teneligliptin as adjunct treatments in insulin-treated patients. This evidence-based discussion summarizes key findings from a randomized controlled trial and explores its clinical implications. Visit https://www.endometaboljournal.com/ for more peer-reviewed insights in endocrinology and metabolic research.

Study Overview and Clinical Background

This randomized, prospective, parallel-group clinical trial evaluated 300 patients with poorly controlled Type 2 diabetes (HbA1c 7.5–10%) despite ongoing insulin, metformin, and glimepiride therapy.

Key Study Parameters

• Participants: Adults aged 18–80 years with longstanding T2DM
• Interventions:
  • Hydroxychloroquine 400 mg once daily
  • Teneligliptin 20 mg once daily
• Duration: 24 weeks
• Primary Endpoint: Change in HbA1c
• Secondary Endpoints: Fasting glucose, post-prandial glucose, insulin dose, lipid profile, and hypoglycemia events

Key Findings Explained Simply

The study demonstrated meaningful differences between the two treatment groups:

• HbA1c reduction:
  • Hydroxychloroquine: −1.2%
  • Teneligliptin: −0.9%
• Fasting and post-prandial glucose levels showed greater improvement with hydroxychloroquine.
• Insulin dose reduction:
  • Hydroxychloroquine group achieved nearly 28% reduction
  • Teneligliptin group showed approximately 19% reduction
• Hypoglycemia events were significantly fewer and less severe in the hydroxychloroquine group.

These results suggest hydroxychloroquine may offer additional glycemic benefits when added to insulin therapy, particularly in patients at high risk of hypoglycemia.

Safety and Tolerability Outcomes

Both treatment arms showed comparable overall safety profiles:

• Adverse events occurred in 72% of hydroxychloroquine users and 77% of teneligliptin users.
• Gastrointestinal symptoms and mild neurological complaints were the most commonly reported events.
• No significant differences were observed in cardiovascular parameters or ECG changes.

Importantly, severe hypoglycemia was notably lower in patients receiving hydroxychloroquine.

Broader Clinical Implications in Diabetes Care

The American Diabetes Association (ADA) emphasizes individualized therapy for patients with advanced Type 2 diabetes, balancing glycemic targets with safety concerns such as hypoglycemia and treatment burden. In this context the findings support hydroxychloroquine as a potential insulin-sparing agent that may enhance metabolic control without increasing adverse risk.

A detailed analysis can be found in our main journal article discussing adjunct pharmacotherapy strategies in insulin-treated diabetes populations.

Further Reading and Resources

Read the full randomized controlled trial at: https://doi.org/10.29328/journal.acem.1001009

For additional endocrinology-focused publications and clinical reviews explore the resources available at endometaboljournal.

Key Takeaways for Clinicians

• Hydroxychloroquine demonstrated superior HbA1c reduction compared to teneligliptin
• Significant insulin dose reduction was observed
• Lower incidence of confirmed and severe hypoglycemia
• Comparable overall safety between treatment groups

Call to Action

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