Disorders of glucose metabolism in the context of human immunodeficiency virus infection

J Am Acad Nurse Pract. 2006 Mar;18(3):92-103. doi: 10.1111/j.1745-7599.2006.00109.x.

Abstract

Purpose: To discuss the pathophysiology and the current treatment approaches for the dysregulation of glucose metabolism in the context of human immunodeficiency virus (HIV) infection.

Data sources: Selected research, clinical studies, clinical guidelines, and review articles.

Conclusions: In HIV infection, multiple factors are associated with the pathogenesis of glucose dysregulation. Studies suggest that protease inhibitors, a class of antiretroviral agent, as well as viral factors, lipodystrophy, hepatitis C infection, injection drug use, and second-generation antipsychotics have been implicated in the development of glucose disorders and diabetes. Current treatment recommendations are based on extrapolated data from non-HIV diabetic patients. More research is needed to establish the most appropriate management for the disorders of glucose metabolism in the context of HIV infection.

Implications for practice: If left untreated, patients are at increased risk for cardiovascular disease and complications associated with untreated diabetes.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Anti-HIV Agents / adverse effects
  • Antidepressive Agents, Second-Generation / adverse effects
  • Antiretroviral Therapy, Highly Active / adverse effects
  • Cardiovascular Diseases / etiology
  • Comorbidity
  • Decision Trees
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / prevention & control
  • Diabetes Mellitus / virology*
  • Feeding Behavior
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Protease Inhibitors / adverse effects
  • HIV-Associated Lipodystrophy Syndrome / complications
  • HIV-Associated Lipodystrophy Syndrome / virology
  • Hepatitis C / complications
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin Resistance
  • Life Style
  • Nursing Assessment
  • Practice Guidelines as Topic
  • Risk Factors
  • Risk Reduction Behavior
  • Substance Abuse, Intravenous / complications

Substances

  • Anti-HIV Agents
  • Antidepressive Agents, Second-Generation
  • HIV Protease Inhibitors
  • Hypoglycemic Agents