Reducing Risk of Type 2 Diabetes: Hydroxychloroquine Use in Pre-Diabetes

Diabetes is approaching epidemic proportions in the United States. This study evaluates the
mechanisms of action of a generic drug that may have effects on glucose metabolism.

Inclusion Criteria:

1. Age > or = 18, able to provide informed consent

2. Body-mass index greater than or equal to 25

3. Presence of at least one indicator of insulin resistance from the following list:

- Family history of Type 2 diabetes (parent, sibling)

- Fasting glucose 100 - 125 mg/dl

- Fasting serum insulin greater than or equal to 7uU/ml

- Personal history of gestational diabetes

4. Negative pregnancy test for women with childbearing potential

Exclusion Criteria:

1. Diagnosis of diabetes mellitus Type 1 or Type 2

2. Active autoimmune disease, chronic infection, current malignancy (excluding basal
cell carcinoma), or other active inflammatory state that, in the opinion of the
investigators, would affect insulin sensitivity

3. Oral corticosteroid use in prior six months, or expectation of needing corticosteroid
therapy in upcoming six months

4. Known allergy or intolerance to HCQ

5. Known glucose-6 phosphate dehydrogenase deficiency

6. Known eye disease associated with retinal pigmentation abnormalities

7. Known diabetic retinopathy requiring past or planned laser therapy

8. Inability to comply with visit schedule and protocol requirements

9. Inability to manage and take medication as instructed

10. Current or planned pregnancy in upcoming 12 months

11. Inability or unwillingness to use reliable method of contraception (for women of
childbearing years, men, or men's partners with childbearing potential), such as oral
contraceptive pills, barrier method (diaphragm and condom with spermicide),
intrauterine device, or depo-provera injections for 3 months prior to enrollment

12. Anemia (HGB < 9)

13. Any history of bariatric (weight loss) surgery

14. Current use of the medication Glucophage (metformin)

15. Weight changes of 6 pounds or more in the past 4 weeks

16. Any other underlying or concomitant condition, which in the opinion of the principal
investigator, could confound the results of the study or put the subject at undue
risk