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01-10-2016 | Diabetes Epidemiology (N Maruthur, Section Editor)

Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes

Authors: Scott J. Pilla, Amy Q. Quan, Emily L. Germain-Lee, David B. Hellmann, Nestoras N. Mathioudakis

Published in: Current Diabetes Reports | Issue 10/2016

Abstract

Immune modulators used to treat rheumatologic disease have diverse endocrine effects in patients with diabetes. Providers should be aware of these effects given that diabetes and rheumatologic disease overlap in prevalence and cardiovascular morbidity. In patients with type 1 diabetes, clinical trials have demonstrated that immune modulators used early in the disease can improve pancreatic function, though their efficacy in adults with longstanding autoimmune diabetes is unknown. In patients with type 2 diabetes, hydroxychloroquine is an effective antihyperglycemic and may be preferred for rheumatologic use in patients with difficult glycemic control. In patients without diabetes, hydroxychloroquine and tumor necrosis factor (TNF) inhibitors have been found to decrease diabetes incidence in observational studies. Additionally, dapsone and sulfasalazine alter erythrocyte survival resulting in inaccurate HbA1c values. These multifaceted effects of immune modulators create a need for coordinated care between providers treating patients with diabetes to individualize medication selection and prevent hypoglycemic events. More research is needed to determine the long-term outcomes of immune modulators in patients with diabetes.

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Title: Immune-Modulating Therapy for Rheumatologic Disease: Implications for Patients with Diabetes
Authors: Scott J. Pilla
Amy Q. Quan
Emily L. Germain-Lee
David B. Hellmann
Nestoras N. Mathioudakis
Publication date: 01-10-2016
Publisher: Springer US
Published in: Current Diabetes Reports / Issue 10/2016
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-016-0792-9

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