Osteoarthritis Drug Diacerein Improves Glycemic Control in Type 2 Diabetes

Diacerein has been studied to treat osteoarthritis of the knees and hips and is an anti-inflammatory medication that works differently from the typical NSAIDS. Diacerein blocks interleukin-1, as opposed to inhibiting the cyclooxygenase (COX) pathway as NSAIDs do.

Diacerein, which reduces levels of TNF-alpha and interleukin (IL)-1-beta, is widely used for arthropathies, although not in the U.S. The researchers who conducted the current study suspected its cytokine-lowering effects could help obese patients with type 2 diabetes improve their glucose control.

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.

Insulin secretion and insulin sensitivity were assessed with hyperglycemic-hyperinsulinemic clamps at baseline and at 2 months.

According to Dr. Manuel Gonzalez-Ortiz with the Mexican Institute of Social Security in Guadalajara, the 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. From baseline to 60 days, the mean fasting glucose level was unchanged in the placebo group (7.8 mmol/L; 140.4 mg/dL) but fell from 7.9 mmol/L (142.2 mg/dL) to 6.8 mmol/L (122.4 mg/dL) in the diacerein group (p<0.001).

Similarly, A1C concentration rose slightly with placebo (from 7.9% to 8.1%) but fell significantly with diacerein, from 8.3% to 7.0% (p<0.001).

The most common adverse effects were gastrointestinal symptoms (9 with placebo, 13 with diacerein) and headache (6 with placebo vs. 5 with diacerein), according to the report.

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