Elsevier

Metabolism

Volume 36, Issue 10, October 1987, Pages 944-948
Metabolism

Impaired glucose handling in active rheumatoid arthritis: Effects of corticosteroids and antirheumatic treatment

https://doi.org/10.1016/0026-0495(87)90129-6Get rights and content

Abstract

Forty-two patients with active rheumatoid arthritis were studied serially with respect to glucose metabolism after the institution of different anti-inflammatory and antirheumatic therapies. Sixteen patients received 20 mg of prednisolone daily. After 1 week of treatment the mean k value in glucose tolerance tests increased from 1.0 ± 0.1 (SEM) to 1.6 ± 0.1 (P < .001). The corticosteroid therapy thus restored the glucose tolerance to normal and significantly enhanced the insulin response (P < .01). Corticosteroids also normalized the growth hormone response to glucose infusion but had no effect on plasma glucagon. Treatment with nonsteroidal anti-inflammatory drugs did not affect the k values nor the hormonal pattern either after short-term treatment or after three months of therapy, except for causing a minor increase in the plasma glucagon levels both before and after glucose infusion. The long-term effects of treatment with penicillamine (n = 4), chloroquine (n = 7), and immunosuppressive agents [corticosteroids combined with azathioprine or cyclophosphamide (n = 7)], were an improvement of the clinical state, a reduction of the inflammatory activity, and a reversal of the glucose handling to normal.

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Supported by the Medical Faculty of Uppsala, the Swedish Medical Research Council, and Pharmacia, Sweden.

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