Resolution Of Diabetes After Initiation Of Antiretroviral Therapy In Two Human Immunodeficiency Virus-Infected Patients |
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| Affiliation: | 1. Canadian HIV Trials Network;2. Department of Medicine, Division of Infectious Diseases, Vancouver, British Columbia, Canada.;3. Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada.;1. Dipartimento di Medicina Veterinaria, Università Aldo Moro di Bari, Italy;2. Dipartimento di Medicina e Chirurgia, Università degli Studi di Parma, Italy;3. Dipartimento di Scienze Biomediche e Oncologia Umana, Università Aldo Moro di Bari, Italy;4. Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza “G. D''Alessandro”, Università di Palermo, Italy;5. Institute for Veterinary Medical Research, Centre for Agricultural Research, Hungarian Academy of Sciences, Budapest, Hungary;6. Division of Viral Products, Food and Drug Administration, Silver Spring, MD, USA;1. Postgraduate Program in Virology, Evandro Chagas Institute, Rodovia BR-316, Km 7 s/n, Levilândia, 67030-000 Ananindeua, Pará, Brazil;2. Virology Section, Evandro Chagas Institute, Brazilian Ministry of Health, Rodovia BR-316, Km 7 s/n, Levilândia, 67030-000 Ananindeua, Pará, Brazil |
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| Abstract: | ObjectiveTo describe two cases of human immunodeficiency virus (HlV)-infected patients who had diabetes mellitus, which resolved after initiation of antiretroviral therapy.MethodsWe present the clinical and laboratory findings and describe the clinical course of these two patients.ResultsA 48-year-old HIV-infected black woman presented with multiple infections and hyperglycemia. After her acute infections were treated and she was feeling well, she continued to have diabetes that necessitated insulin therapy. Administration of a protease inhibitor-based antiretroviral regimen resolved her diabetes and eliminated the need for insulin or oral therapy. Our second patient, a 37-year-old HIV-infected black man, presented with polyuria and polydipsia and a hemoglobin A1c value of 11%. He received antiretroviral therapy, and his diabetes resolved after a period of 2½ months.ConclusionProtease inhibitor-based antiretroviral therapy is associated with diabetes mellitus in up to 6% of HIV-infected patients. Although most HIV-infected patients in whom diabetes develops have this disorder after initiation of protease inhibitor therapy, the current two cases illustrate patients in whom diabetes resolved after use of antiretroviral therapy. This finding supports the presence of other mechanisms that affect glucose metabolism in patients infected with HIV and suggests that control of HIV infection may have a role in controlling diabetes. (Endocr Pract. 2004;10:199-202) |
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