Impaired Glucose Tolerance and Protease Inhibitors

Letters15 November 1998Impaired Glucose Tolerance and Protease InhibitorsRavi Walli, MD, Frank D. Goebel, MD, and Thomas Demant, MDRavi Walli, MDMedizinische Poliklinik; Munich, GermanyKlinikum Grossharden; Munich, Germany, Frank D. Goebel, MDMedizinische Poliklinik; Munich, GermanyKlinikum Grossharden; Munich, Germany, and Thomas Demant, MDMedizinische Poliklinik; Munich, GermanyKlinikum Grossharden; Munich, GermanyAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-129-10-199811150-00022 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Protease inhibitors are a crucial component of highly active antiretroviral therapy for HIV infection. However, the use of these drugs is associated with hyperglycemia, hyperlipidemia, and lipodystrophy [1-3]. The underlying mechanisms leading to these metabolic alterations are unknown. We evaluated peripheral insulin sensitivity in 24 HIV-positive patients treated with protease inhibitors, 8 therapy-naive HIV-positive patients, and 18 HIV-negative controls (Figure 1) using an intravenous insulin tolerance test [4].Figure 1.Insulin sensitivity of 18 HIV-negative controls (squares), 8 HIV-positive therapy-naive patients (diamonds), and 24 HIV-positive patients treated with protease inhibitors (11 with normal glucose tolerance [black triangles] and ...References1. Hengel RL, Watts NB, Lennox JL. Benign symmetric lipomatosis associated with protease inhibitors. Lancet. 1997; 350:1596. Google Scholar2. Eastone JA, Decker CF. New-onset diabetes mellitus associated with use of protease inhibitor [Letter]. Ann Intern Med. 1997; 127:948. Google Scholar3. Walli R, Herfort O, Michl GM, Demant T, Dieterle C, Bogner JR, et al. Peripheral insulin resistance leading to impaired glucose tolerance in HIV-1 infected patients treated with protease inhibitors [Abstract]. Proceedings of the Third European Conference on Experimental AIDS Research. March 1998, Munich. Google Scholar4. Gelding SV, Robinson S, Lowe S, Niththyananthan R, Johnston DG. Validation of the low dose short insulin tolerance test for evaluation of insulin sensitivity. Clin Endocrinol (Oxf). 1994; 40:611-5. Google Scholar Author, Article, and Disclosure InformationAuthors: Ravi Walli, MD; Frank D. Goebel, MD; Thomas Demant, MDAffiliations: Medizinische Poliklinik; Munich, GermanyKlinikum Grossharden; Munich, Germany PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIncidence and associated factors of type 2 diabetes mellitus onset in the Brazilian HIV/AIDS cohort studyCoronary artery disease in patients with human immunodeficiency virus infectionPsychosocial complications of HIV/AIDS-metabolic disorder comorbidities among patients in a rural area of southeastern United StatesHIV Infection and DiabetesHIV Associated Non-AIDS Conditions in Patients Aging with HIVHIV Infection and DiabetesHIV, Inflammation, and Calcium in AtherosclerosisVitamin D and Insulin Resistance in Non-Diabetic Women's Interagency HIV Study ParticipantsNeuroimaging studies of the aging HIV-1-infected brainPathology and Management of Periodontal Problems in Patients with HIV InfectionInsulin-like growth factor-I-forkhead box O transcription factor 3a counteracts high glucose/tumor necrosis factor-α-mediated neuronal damage: Implications for human immunodeficiency virus encephalitisHIV Infection and DiabetesLong term adverse effects related to nucleoside reverse transcriptase inhibitors: Clinical impact of mitochondrial toxicityAntiretroviral Therapy Exposure and Insulin Resistance in the Women's Interagency HIV StudyThe Endocrine SystemImprovement in Insulin Sensitivity and Dyslipidemia in Protease Inhibitor-Treated Adult Male Patients after Switch to Atazanavir/RitonavirBrief Report: Insulin Resistance Is Affected by Increased Levels of Plasma Lactate but not Mitochondrial Alterations in Skeletal Muscle in NRTI-Exposed HIV-Infected PatientsAntiretroviral therapy exposure and incidence of diabetes mellitus in the Women's Interagency HIV StudyHIV-Associated Renal Diseases and Highly Active Antiretroviral Therapy--Induced NephropathyIncidence of and Risk Factors for Insulin Resistance in Treatment-Naive HIV-Infected Patients 48 Weeks after Starting Highly Active Antiretroviral TherapyDrug-induced diabetes mellitusOral Glucose Tolerance and Insulin Sensitivity Are Unaffected by HIV Infection or Antiretroviral Therapy in Overweight WomenDiabetes, Insulin Resistance, and Dementia Among HIV-1-Infected PatientsAge, apolipoprotein E4, and the risk of HIV dementia: the Hawaii Aging with HIV CohortCardiology and AIDS—HAART and the ConsequencesStavudine Versus Zidovudine and the Development of LipodystrophyStavudine Versus Zidovudine and the Development of LipodystrophyReduced Reactive Hyperemia in HIV-Infected PatientsReduced Reactive Hyperemia in HIV-Infected PatientsProtease Inhibitor-Associated Hyperglycemia in Mexican Patients with HIV InfectionHyperlipidemia under treatment with proteinase inhibitors 15 November 1998Volume 129, Issue 10Page: 837-838KeywordsGlucose toleranceHighly active antiretroviral therapyHyperglycemiaHyperlipidemiaInsulin resistanceInsulin secretionLipodystrophyOral glucose tolerance testProtease inhibitor therapyProtease inhibitors ePublished: 15 August 2000 Issue Published: 15 November 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. 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