Author(s): Hussam M. Gharib, Mohammad Y. Abajy, Abdulnaser Omaren


DOI: 10.5958/0974-360X.2020.01045.8   

Address: Hussam M. Gharib1, Mohammad Y. Abajy2, Abdulnaser Omaren1
1Department of Pharmacology, Faculty of Pharmacy, Damascus University, Syria.
2Department of Biochemistry, Faculty of Pharmacy, Aleppo University, Syria.
*Corresponding Author

Published In:   Volume - 13,      Issue - 12,     Year - 2020

Fluoroquinolone antibiotics may cause acute disorders in blood glucose levels, this side effect is worthwhile, especially in diabetic patients, this study aimed to investigate the effect of each of two fluoroquinolones, moxifloxacin and levofloxacin, on blood glucose levels in STZ-induced diabetic wistar rats after induction of a type 2-like diabetes, and ensuring the stability of the diabetic condition, as well as waiting for aging (4 months). Experimental animals were divided into four groups: group 1; diabetic animals were treated with moxifloxacin (n=15), group 2; diabetic animals were treated with levofloxacin (n=15), group 3; diabetic control animals (n=15), and group 4; non-diabetic control animals (n=6), insulin levels, body weights, and blood glucose levels were compared at different times for a period of 14 days during the treatment with fluoroquinolones. Fluoroquinolones reduced blood glucose levels, this effect was greater with levofloxacin than moxifloxacin, accompanied with high insulin levels with levofloxacin more than moxifloxacin. There were no statistically significant differences in body weights after treating with fluoroquinolones, in conclusion: there are dissimilarity in the effect of moxifloxacin and levofloxacin on blood glucose and Insulin levels in type-2 diabetes, inspite of the importance of these compounds in the treatment of resistant infections on other antibiotics, it is necessary to exercise caution when using these compounds in diabetic patients through the precautional monitoring of blood glucose levels.

Cite this article:
Hussam M. Gharib, Mohammad Y. Abajy, Abdulnaser Omaren. Investigating the effect of Some Fluoroquinolones on Blood Glucose and Insulin levels in STZ-Induced Diabetic Wistar Rats. Research J. Pharm. and Tech. 2020; 13(12):5993-5998. doi: 10.5958/0974-360X.2020.01045.8

Hussam M. Gharib, Mohammad Y. Abajy, Abdulnaser Omaren. Investigating the effect of Some Fluoroquinolones on Blood Glucose and Insulin levels in STZ-Induced Diabetic Wistar Rats. Research J. Pharm. and Tech. 2020; 13(12):5993-5998. doi: 10.5958/0974-360X.2020.01045.8   Available on:

1.    World Health Organization, Geneva. Global report on diabetes. 2016.
2.    Krssak M, Brehm A, Bernroider E, Anderwald C, Nowotny P, Man CD, Cobelli C, Cline GW, Shulman G, Waldhäusl W, Roden M. Alterations in Postprandial Hepatic Glycogen Metabolism in Type 2 Diabetes. Diabetes. 2004; 53(12): 3048-3056.
3.    Akirov A, Grossman A, Shochat T, Shimon I. Mortality Among Hospitalized Patients With Hypoglycemia: Insulin Related and Noninsulin Related. The Journal of Clinical Endocrinology and Metabolism. 2016; 102(2): 416-424.
4.    Aspinall SL, Good CB, Jiang R, McCarren M, Dong D, Cunningham FE. Severe Dysglycemia with the Fluoroquinolones: A Class Effect?. Clinical Infectious Diseases. 2009; 49(3): 402-408.
5.    Chou HW, Wang JL, Chang CH, Lee JJ, Shau WY, Lai MS. Risk of severe dysglycemia among diabetic patients receiving levofloxacin, ciprofloxacin, or moxifloxacin in Taiwan. Clinical Infectious Diseases. 2013; 57(7):971-980.
6.    Ishiwata Y, Itoga Y, Yasuhara M. Effects of levofloxacin on serum glucose concentration in rats. European Journal of Pharmacology. 2006; 551, 168-174.
7.    Kelesidis T, Canseco E. Levofloxacin-induced hypoglycemia: a rare but life-threatening side effect of a widely used antibiotic. The American Journal of Medicine. 2009; 122, 3-4.
8.    Karzoon A, Abdelwahed W, Nayal R. Evaluation of hypoglycemic effect of Achillea biebersteinii Afan, growing in Syria, in induced diabetic rats. International Journal of Pharmacognosy and Phytochemical Research. 2017; 9(2): 215-222.
9.    Pramila K, JuliusA. Antihyperglycemic, Antidyslipidemic and Antifibrotic effect of EGCG in STZ - High Fat Diet Induced DCM rats. Research Journal of Pharmacy and Technology. 2019; 12(4).
10.    Skovso S. Modeling type 2 diabetes in rats using high fat diet and streptozotocin. Journal of Diabetes Investigation. 2014; 5: 349–358.
11.    Goyal SN, Reddy NM, Patil KR, Nakhate KT, Ojha S, Patil CR, Agrawal YO. Challenges and Issues with Streptozotocin-Induced Diabetes – A Clinically Relevant Animal Model to Understand the Diabetes Pathogenesis and Evaluate Therapeutics. Chemico-Biological Interactions. 2016; 244: 49-63.
12.    Sun M, Yokoyama M, Ishiwata T, Asano G. Deposition of advanced glycation end products (AGE) and expression of the receptor for AGE in cardiovascular tissue of the diabetic rat. International Journal of Experimental Pathology. 1998; 79(4), 207–222.
13.    Gao L, Mann GE. Vascular NAD(P)H oxidase activation in diabetes: a double-edged sword in redox signaling. Cardiovascular Research. 2009; 82, 9-20.
14.    Murillo O, Pachon ME, Euba G, Verdaguer R, Tubau F, Cabellos C, Cabo J, Gudiol F, Ariza J. High doses of Levofloxacin vs Moxifloxacin Against Staphylococcal Experimental Foreign-Body Infection: The Effect of Higher MIC-Related Pharmacokinetic Parameters on Efficacy. Journal of Infection. 2009; 58: 220-226.
15.    Sada riya KA, Gothi AK, Patel SD, Bhavsar SK, Thaker AM. Safety of Moxifloxacin Following Repeated Intramuscular Administration in Wistar Rats. Veterinary World. 2010; 3(10):449-452.
16.    Langtry HD, Lamb HM. Levofloxacin. Its use in infections of the respiratory tract, skin, soft tissues and urinary tract. Drugs. 1999; 56(3):487-515.
17.    Olsen KM, Gentry-Nielsen M, Yue M, Snitily MU, Preheim LC. Effect of Ethanol on Fluoroquinolone Efficacy in a Rat Model of Pneumococcal Pneumonia. Antimicrobial Agents and Chemotherapy. 2006; 50: 210-219.
18.    Braslasu ED, Bradatan C, Cornila M, Savulescu I, Cojmaleata R, Braslasu MC. Normal blood glucose in white wistar rat and its changes following anesthesia. LUCRĂRI ṢTIINłIFICE MEDICINĂ VETERINARĂ. 2007; 120-123.
19.    Chang JS, You YH, Park SY, Kim JW, Kim HS, Kun-Ho Yoon KH, Jae-Hyoung Cho JH. Pattern of Stress-Induced Hyperglycemia according to Type of Diabetes: A Predator Stress Model. Diabetes and metabolism journal. 2013; 37:475-483.
20.    Gharib HM, Abajy MY, Omaren A. Investigating the effect of some fluoroquinolones on C-reactive protein levels and ACh-Induced blood pressure reduction deviations after aging of diabetes in STZ-Induced diabetic wistar rats. Heliyon 6 (2020) e03812.
21.    Koksal B. Effect of Streptozotocin on Plasma Insulin Levels of Rats and Mice: A Meta-analysis Study. Open Access Macedonian Journal of Medical Sciences. 2015; 3(3):380-383.
22.    Akbarzadeh A, Norouzian D, Mehrabi MR, Jamshidi Sh, Farhangi A, Verdi AA, Mofidian SMA, Lame Rad B. Induction of Diabetes by Streptozotocin in Rats. Indian Journal of Clinical Biochemistry. 2007; 22(2): 60-64.
23.    Wang HJ, Jin YX, Shen W, Neng J, Wu T, Li YJ, Fu ZW. Low dose streptozotocin (STZ) combined with high energy intake can effectively induce type 2 diabetes through altering the related gene expression. Asia Pacific Journal of Clinical Nutrition. 2007; 16, 412-417.
24.    Gürpinar AN, Balkan E, Kiliç N, Kiriştioğlu I, Doğruyol H. The effects of a fluoroquinolone on the growth and development of infants. Journal of International Medical Research. 1997; 25(5): 302-306.
25.    Kabbara WK, Ramadan WH, Rahbany P, Al-Natour S. Evaluation of the appropriate use of commonly prescribed fluoroquinolones and the risk of dysglycemia. Therapeutics and Clinical Risk Management. 2015; 11: 639–647.
26.    Sullivan MG. Fluoroquinolones can cause fatal hypoglycemia, FDA warns. MDedge News. 2018.
27.    Owens RC, Ambrose PG. Antimicrobial Safety: Focus on Fluoroquinolones. Clinical Infectious Diseases. 2005; 41:S144–57.
28.    Saraya A, Yokokura M, Gonoi T, Seino S. Effects of fluoroquinolones on insulin secretion and β-cell ATP-sensitive K+ channels. European Journal of Pharmacology. 2004; 497, 111-117.
29.    Hori S, Kizu J, Kawamura M. Effect of fluoroquinolones on plasma glucose levels in fasted and glucose-loaded mice. Journal of Infection and Chemotherapy. 2006; 12, 109-111.
30.    Gavin JR, Kubin R, Choudhri S, Kubitza D, Himmel H, Gross R, Meyer JM. Moxifloxacin and glucose homeostasis: a pooled-analysis of the evidence from clinical and postmarketing studies. Drug Safety. 2004; 27, 671-686.
31.    Ishiwata Y, Takahashi Y, Nagata M, Yasuhara M. Effects of Moxifloxacin on Serum Glucose Concentrations in Rats. Biol Pharm Bull. 2013; 36(4), 686-690.
32.    Brunton LL, Dandan RH, Knollmann BC. Goodman and gilman,s the pharmacological basis of therapeutics. 13th edition. 2018.
33.    Bito M, Tomita T, Komori M, Taogoshi T, Kimura Y, Kihira K. The mechanisms of insulin secretion and calcium signaling in pancreatic β-cells exposed to fluoroquinolones. Biological and Pharmaceutical Bulletin. 2013; 36(1):31-5.
34.    Ishiwata Y, Yasuhara M. Gatifloxacin-induced histamine release and hyperglycemia in rats. European Journal of Pharmacology. 2010; 645, 192-197.
35.    Nagai M, Nagata S, Yamagishi N, Satoh H, Furuhama K. Clinicopathological aspect of dysglycemia in native and diabetic rats induced by the fluoroquinolone antibacterial gatifloxacin. Toxicology. 2010; 72, 567-537.
36.    Yamada C, Nagashima K, Takahashi A, Ueno H, Kawasaki Y, Yamada Y, Seino Y, Inagaki N. Gatifloxacin acutely stimulates insulin secretion and chronically suppresses insulin biosynthesis. European Journal of Pharmacology. 2006; 553, 67-72.
37.    Berhe A, Russom M, Bahran F and Hugos G (2019). Ciprofloxacin and risk of hypoglycemia in non-diabetic patients. J Med Case Reports 13: 142.
38.    Vallurupalli S, Huesmann G, Gregory J, Jakoby MG. Levofloxacin-associated hypoglycaemia complicated by pontine myelinolysis and quadriplegia. Diabetic Medicine. 2008; 25: 856-859.
39.    Mandavia DR, Virpariya MM, Patel TK, Tripathi CB. Moxifloxacin-induced Hypoglycemia in a Non-diabetic Patient. Current Drug Safety. 2012; 7: 183-185.
40.    Kapoor R, Blum D, Batra A, Varma N, Lakshmi K, Basak P, Jesmajian S. Life-Threatening Hypoglycemia With Moxifloxacin in a Dialysis Patient. The Journal of Clinical Pharmacology. 2012; 52: 269-271.
41.    Singal DK, Mittal A, Prakash A. Recurrent episodes of hypoglycemia induced by moxifloxacin. Indian Journal of Pharmacology. 2013; 45(3): 301–302.

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