Stephen J.LurieMD, PhD, Senior EditorIndividualAuthor
Copyright 2002 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2002
To the Editor: In their Contempo Updates article
about drug-induced hyperglycemia,1 Drs Luna
and Feinglos did not mention glucosamine sulfate, a drug that is increasingly
used in the treatment of osteoarthritis.2
By increasing glucose flux through the hexosamine biosynthetic pathway,
glucosamine has been shown to induce insulin resistance in skeletal muscle.3 Furthermore, acceleration of the hexosamine pathway
also inhibits glucose-induced insulin secretion, resulting in hyperglycemia.4 In a case report of a patient with disabling hypoglycemic
symptoms caused by metastatic insulinoma, the use of glucosamine for osteoarthritis
led to marked improvement of these symptoms.5
In industrialized countries where people are becoming increasingly overweight
and thus at increased risk of osteoarthritis, the diabetogenic effect of glucosamine
must be considered.
Chan NN, Osaki R, Chow CC, Chan JCN, Cockram CS. Drug-Related Hyperglycemia. JAMA. 2002;287(6):714-715. doi:10.1001/jama.287.6.711