IndraLab

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"Proposed mechanisms include improving insulin sensitivity, enhancing insulin dependent glucose transport, and decreasing the degradation of intracellular insulin.S1 A study demonstrated that HCQ could increase insulin secretion and improve blood glucose levels in prediabetic patients.S2 Another trial also showed that chloroquine could lower glucose levels in diabetic patients with a similar mechanism.S3 HCQ induced hypoglycemia in the nondiabetic population is quite rare."
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"Additionally, HCQ elicits this hypoglycemic effect by reducing the rate of glucose receptor recycling, and also by promoting insulin dependent cellular uptake of glucose."
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"Smith et al. in 1987 described a significant improvement of glycemic values in few patients with non insulin dependent diabetes mellitus treated with HCQ XREF_BIBR."
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"It is concluded that HCQ significantly elevated insulin blood concentration resulting in reduced glucose levels in a concentration dependent fashion in diabetic rats."
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"Hydroxychloroquine prevents insulin degradation in the liver and suppresses gluconeogenesis, increasing peripheral utilization of glucose; so, it is particularly attractive to use in patients also treated with corticosteroids."
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"Hydroxychloroquine (HCQ) has been found to significantly increase the insulin sensitivity index (ISI) and show a tendency to reduce IR (as assessed by the homeostatic model assessment for insulin resistance [HOMA-IR]) [XREF_BIBR]."
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"Hydroxychloroquine decreases insulin degradation at the cellular level, increases intracellular insulin accumulation, and stimulates insulin mediated glucose transport [XREF_BIBR]."
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"Additionally, HCQ elicits this hypoglycemic effect by reducing the rate of glucose receptor recycling, and also by promoting insulin dependent cellular uptake of glucose (Cynober et al., 1987)."
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"HCQ increases insulin sensitivity and reduces insulin resistance through its indirect effect by reducing inflammation [48]."
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"Patients with SLE taking an antimalarial agent have also been shown to have lower fasting blood glucose conentrations - a risk factor for premature atherosclerosis - compared with controls [XREF_BIBR], and one study demonstrated that hydroxychloroquine prolongs the half-life of the active insulin and receptor complex via inhibition of the insulin-receptor dissociation, thus augmenting insulin stimulated responses [XREF_BIBR]."
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"Thus, hydroxychloroquine therapy in COVID-19 may lead to hypoglycemia since this drug reduces insulin degradation and improves insulin storage with augmentation of peripheral glucose metabolism (59) ."
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