Diabetes Mellitus and Insulin Resistance
is a topic covered in the Johns Hopkins HIV Guide
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- Insulin resistance (IR) common in HIV+ pts on ART.
- Diabetes mellitus (DM) less common, but still 2-4x higher than in general population.
- IR also caused by fat accumulation (lipodystrophy). In general population (and presumably in HIV+ pts), IR increases risk for coronary artery disease.
- Risk factors for IR/DM: abdominal fat accumulation, peripheral lipoatrophy, family Hx of DM, obesity, age, HCV, low CD4 nadir, black/Hispanic race.
- Consider role of other medications: corticosteroids, growth hormone, megestrol acetate, immunosuppressants, atypical antipsychotics.
- Older PIs (IDV, full dose RTV) have marked effects on IR. Of the current PIs, LPV/r > DRV/r and ATV/r. Independent effect of low dose RTV on IR controversial.
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Last updated: November 29, 2011
Brown, Todd T, and Joseph Cofrancesco. "Diabetes Mellitus and Insulin Resistance." Johns Hopkins HIV Guide, 2011. Johns Hopkins Guide, www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545106/4/Diabetes_Mellitus_and_Insulin_Resistance.
Brown TT, Cofrancesco J. Diabetes Mellitus and Insulin Resistance. Johns Hopkins HIV Guide. 2011. https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545106/4/Diabetes_Mellitus_and_Insulin_Resistance. Accessed October 15, 2019.
Brown, T. T., & Cofrancesco, J. (2011). Diabetes Mellitus and Insulin Resistance. In Johns Hopkins HIV Guide. Available from https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545106/4/Diabetes_Mellitus_and_Insulin_Resistance
Brown TT, Cofrancesco J. Diabetes Mellitus and Insulin Resistance [Internet]. In: Johns Hopkins HIV Guide. ; 2011. [cited 2019 October 15]. Available from: https://www.hopkinsguides.com/hopkins/view/Johns_Hopkins_HIV_Guide/545106/4/Diabetes_Mellitus_and_Insulin_Resistance.
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