Background:
Dapsone treatment may reduce HbA1c levels in patients with diabetes.
Aims:
To assess the prevalence and characteristics of dapsone associated reduction of HbA1c in patients with Hansen’s disease.
Methods:
A retrospective data review of outpatient and inpatient charts of consecutive patients with Hansen’s disease and type 2 diabetes mellitus was conducted over two years from January 2014 to January 2016 at the Department of Dermatology, CMC Vellore, India.
Results:
Of the 245 patients with a confirmed diagnosis of Hansen’s disease who were on oral dapsone 100 mg/day as part of their treatment regimen, 49 patients had diabetes and were eligible for the study as per predetermined inclusion criteria. Of these, 35 subjects (71%) had an HbA1c discordantly lower than the corresponding mean plasma glucose levels. Patients with discordant HbA1c levels were more likely to be male and to have a higher RBC mean corpuscular volume (MCV). A greater reduction in HbA1c levels was seen during the initial 3 months of therapy of dapsone treatment.
Limitations:
The small sample size and retrospective design were limitations of this study. Also, we did not analyze the role of methemoglobinemia or the utility of alternative measures of glycemic control in these patients.
Conclusion:
We describe a high prevalence of dapsone associated inappropriate HbA1c lowering in type 2 diabetes mellitus patients. This may have serious implications for the management of diabetes in patients on therapy with dapsone.
initiation and 65% thereafter for AF and 53% and 59% respectively for VTE. There was a positive relationship between number of visits during initiation and the number of subsequent visits (correlation coefficient (r)ϭ0.29) and a negative relationship between number of visits and TTR during both initiation (rϭ-0.3) and maintenance (rϭ-0.35). CONCLUSIONS: Increasing number of anticoagulation visits was associated with reduced time in range suggesting that despite increased monitoring some patients fail to stay in range. In addition, patients who require frequent visits during the initiation phase continue to do so during maintenance, suggesting that this may be a useful predictor for patients who are likely to be poorly controlled despite high resource use in the longer term and may hence be candidates for alternative means of anticoagulation.
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