Persistent hypoglycemia in a patient with diabetes taking etanercept for the treatment of psoriasis.
We report a patient with type 2 diabetes mellitus who, while treated with the antitumor necrosis factor-alpha blocking agent etanercept for severe plaque psoriasis, experienced persistent hypoglycemia requiring the lowering and eventual elimination of his previous insulin regimen. After 20 months of therapy on etanercept, his plaque psoriasis markedly improved, whereas both his fasting blood sugars and glycosylated hemoglobin A(1c) decreased. Hypoglycemia can be a serious side effect of etanercept in patients already on antidiabetic medications known to cause hypoglycemia, such as sulfonylureas, meglitinides, and insulin. Thus, it is important for dermatologists treating patients with diabetes and antitumor necrosis factor-alpha agents for psoriasis to be aware of potential hypoglycemia and to adjust antidiabetes therapy accordingly.
Cheung
Dianne
D
Department of Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California, USA.
Bryer-Ash
Michael
M
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D000068800:Etanercept; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced*; D007074:Immunoglobulin G / Q000009:adverse effects*; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D011565:Psoriasis / Q000188:drug therapy*; D018124:Receptors, Tumor Necrosis Factor
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000068800:Etanercept; D006442:Glycated Hemoglobin; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; C517652:hemoglobin A1c protein, human