A pill with a lupus butterfly on one side, and a mosquito on the other.

Antimalarial Drugs May Protect People With Lupus from Developing Type 2 Diabetes

Antimalarial drugs are commonly used by people with lupus.1 These drugs ease symptoms like rashes, mouth sores, and joint pain.1 A 2020 study found that antimalarial drugs lower the risk of type 2 diabetes in people with lupus.2 This effect is seen only in those who take their drugs regularly.2

Lupus and its treatments can raise your risk of diabetes.3Type 2 diabetes damages your organs.2 This makes lupus harder to treat.2 Taking your antimalarials regularly may be the best way to stay healthy.

Antimalarials ease lupus symptoms

Hydroxychloroquine (Plaquenil®) and chloroquine (Aralen®) are antimalarials used to treat lupus.1 These drugs ease the symptoms of lupus. People on antimalarials have fewer flare-ups and less organ damage.2 Antimalarials work best when taken regularly over a long period of time.1

Research on hydroxychloroquine and diabetes

A 2020 study showed that hydroxychloroquine, taken regularly, lowers the risk of diabetes.2 Participants in the study were labeled as adherent or non-adherent. Adherent people (or people who followed the treatment as instructed) took at least 90 percent of their hydroxychloroquine, and non-adherent people took the drug irregularly.2 Adherent people were 39 percent less likely to get diabetes compared to those, not on hydroxychloroquine.1,4 Non-adherent people were only 22 percent less likely to get diabetes.1,4

The study tracked 1,448 people over 4 to 5 years.2 Ninety percent were women.2 The average age was 44 years old, and all were given hydroxychloroquine by doctors.2 One drawback of this study is that it does not give statistics to back up its data.

Other studies show the same results

A 2015 study followed 8,628 people with lupus and found that those taking 200 milligrams (mg) of hydroxychloroquine daily were 74 percent less likely to get diabetes.3 Taking less than 200 mg of hydroxychloroquine did not protect against diabetes.3 More information about the history and lifestyle of the participants is needed. Doctors could then adjust for these factors and get a better view on how effective hydroxychloroquine is at controlling diabetes.3

Taking steroids raises the risk of diabetes

For people with lupus, taking at least 10 mg of steroids daily raises the risk of diabetes.3 Steroids may make your body worse at turning food into energy. This raises your risk of diabetes.3 Taking 200 mg of hydroxychloroquine reverses the effect of steroids on your body. Simply stated, hydroxychloroquine cancels out the extra diabetes risk that comes from taking steroids.

Taking hydroxychloroquine

A study of 2,028 people with lupus found that 22 percent do not take hydroxychloroquine as prescribed.5 Culture has some effect on adherence. African Americans, Native Americans, Pacific Islanders, and Middle Eastern people were the least likely of all races to take their drugs as prescribed.5 Doctors are not sure why this is. It has been shown that if the hydroxychloroquine comes from a rheumatologist, people are twice as likely to take the drug regularly.5

Hydroxychloroquine side effects

Hydroxychloroquine works better if it is taken over a long period of time.1 Some people noticed changes in their vision over time.5 People on antimalarials are urged to see an eye doctor each year to make sure their eyes are healthy.

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