Remission of Uncontrolled Type 2 Diabetes Mellitus in a Patient Treated with Tumor Necrosis Factor-Inhibitor: A Case Report
Srikanta Banerjee, Health Sciences Department, University of Roehampton, London, United Kingdom.
Raxit Patel, Department of Internal Medicine, Christus Spohn Hospital, Alice, TX, United States.
Biological agents that have recently been an important treatment of choice for ankylosing spondylitis due to the reduction of inflammation of the axial skeleton and joints through tumor necrosis factor blockade, have multiple therapeutic and adverse side effects. Out of all the side effects reported, one of the underexplored potential therapeutic side effects is remission of diabetes. We report a case of a diabetic Caucasian woman who developed continued glycemic control after treatment with a tumor necrosis factor-alpha inhibitor, etanercept. Additionally, we present a graphical account of fluctuations of glycosylated Hemoglobin (HbA1c) and C-reactive protein associated with etanercept treatment, and we provide a detailed discussion of the implications of this therapeutic side effect. Health care professionals need to be aware of the potentially therapeutic side effect of tumor necrosis factor-alpha inhibitors and should exercise caution when using it in conjunction with exogenous insulin and or oral hypoglycemic drugs. Randomized double blind controlled studies need to assess the efficacy of biologic agents as a potential treatment against type 2 diabetes especially in those individuals with inflammatory arthritis.
Ankylosing Spondylitis, Etanercept, Tumor Necrosis Factor-Alpha Inhibitor, Diabetes, Rheumatic Diseases, Inflammatory
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