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J Med Case Rep. 2012 Jan 10;6:5. doi: 10.1186/1752-1947-6-5.

Development of low blood glucose readings in nine non-diabetic patients treated with tumor necrosis factor-alpha inhibitors: a case series.

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  • 1Department of Rheumatology, Largo Medical Center, Nova Southeastern University College of Osteopathic Medicine, 2025 Indian Rocks Road S, Largo, FL 33774, USA. jadwiga.czajkowska@mwumail.midwestern.edu.

Abstract

INTRODUCTION:

Treatment with various biological agents in disease states such as rheumatoid arthritis has been associated with multiple side effects. Whereas many of these are frequently reported in the literature, hypoglycemia, a possible side effect of tumor necrosis factor-alpha inhibitors, may be underpublicized.

CASE PRESENTATION:

We report nine cases of non-diabetic Caucasian women who were between 29 and 68 years of age and who developed low glucose readings after treatment with tumor necrosis factor-alpha inhibitors. We provide a more detailed discussion of existing evidence of the role of tumor necrosis factor-alpha in the pathogenesis of inflammation and its impact on glycemic equilibrium.

CONCLUSIONS:

Physicians using tumor necrosis factor-alpha inhibitors in the treatment of various rheumatic and other autoimmune diseases should be aware of the potential for the development of glycemic disturbance in these patients. A further role of tumor necrosis factor-alpha inhibitors in the glycemic equilibrium warrants larger controlled trials in patients with and those without a history of diabetes.

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