“There are at least 10 years of basic science data that suggest that inflammation is related to insulin resistance,” explains Dr. Solomon. “So it may be that drugs that work on those specific aspects of inflammation are particularly good at improving insulin metabolism.”

But Dr. Solomon and others stress that it’s far too early for doctors to change the RA medications they're prescribing for patients to take advantage of this possible benefit.

“Although these findings are exciting and important, especially when considering the problem of cardiovascular disease in patients with rheumatoid arthritis and psoriasis, it’s too early to draw any conclusions for clinical management,” says rheumatologist Tim Bongartz, MD, an assistant professor of medicine at the Mayo Clinic in Rochester, Minn., and the co-author of an editorial accompanying this study. “There’s clearly more work needed to confirm these findings and see how they could be used in a clinical setting.”

Still, although there are no guarantees based on one study, Dr. Bongartz says that, as a clinician, he is hopeful that this finding offers the possibility of one day reducing a patient’s pill burden by addressing inflammatory conditions and diabetes with one medication.

“If you look at a patient with rheumatoid arthritis, our increasing knowledge about all the associated problems with inflammatory disease is also somewhat of a curse. We know about the association with osteoporosis, so they get calcium and vitamin D. We know about a strong association with cardiovascular disease, so we are aggressive with managing risk factors. If you are able to utilize medications which are able to hit two birds with one stone – really reducing the pill burden we put on our patients – I think that would be significant progress and help us to improve compliance,” Dr. Bongartz says.

If other studies confirm these findings, it may become standard practice to assess insulin resistance in patients with inflammatory disease, says Dr. Solomon. But this study alone will not lead to that.

He and his research team are now testing this hypothesis in a National Institutes of Health-funded randomized clinical trial of hydroxychloroquine in RA patients. Until the results of those and other related studies are in, he says patients and providers would do best to focus on lifestyle modifiers, such as exercise and weight loss, that reduce the risk of diabetes.