NEW YORK (Reuters Health) – Results of a Mexican study indicate that 2 months of treatment with the antiinflammatory agent diacerein increases insulin secretion and improves A1C levels in patients with type 2 diabetes.

The findings are reported in the May 24 online issue of Diabetes Care by Dr. Manuel Gonzalez-Ortiz and colleagues with the Mexican Institute of Social Security in Guadalajara. They explain that diacerein, which is available in some countries (not apparently in the US) for the treatment of arthropathies, reduces levels of TNF-alpha and interleukin (IL)-1-beta.

The team reasoned that the drug might decrease cytokine levels in obese patients with type 2 diabetes, thus increasing insulin levels and improving glucose control. To test this, they randomized 40 drug-naive adults with type 2 diabetes to placebo treatment or 50 mg/d diacerein for 15 days followed by 50 mg BID for 45 days.

A hyperglycemic-hyperinsulinemic clamp was performed at baseline and at 2 months to assess insulin secretion and insulin sensitivity. The team reports that first phase, late phase and total insulin secretion decreased over the study period in the placebo group but increased significantly in the diacerein group. For example, with diacerein, total insulin secretion increased from 178 pmol/L at baseline to 216 pmol/L (p<0.01) at 60 days.

Fasting glucose levels were unchanged at 7.8 mmol/L from baseline to 60 days in the placebo group, but decreased from 7.9 mmol/L to 6.8 mmol/L (p<0.001) in the diacerein group, the investigators found.

Similarly, A1C concentration increased somewhat among patients given placebo (from 7.9% to 8.1%) but showed a significant drop from 8.3% to 7.0% (p<0.001) in those receiving diacerein.

The most common adverse effects reported were gastrointestinal symptoms (9 placebo patients and 13 diacerein recipients) and headache (6 in the placebo group vs 5 in the diacerein arm), according to the report.

“Our results suggest that diacerein administration may have a potential usefulness in the treatment of type 2 diabetes,” Dr. Gonzalez-Ortiz and colleagues conclude. “Further studies are needed to test long-term administration, as well as to explore its use in combination with other pharmacological options.”

Reference:
Effect of Diacerein on Insulin Secretion and Metabolic Control in Drug-Naïve Patients With Type 2 Diabetes
Diabetes Care 2011.