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HIV and diabetes

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Research suggests that anti-retroviral therapy (ART) may cause diabetes in some HIV-positive people.

The three drugs in the anti-retroviral drug “cocktail” are a protease inhibitor (PI) and two nucleoside reverse transcriptase inhibitors (RTIs). These drugs help stop the virus from replicating and spreading throughout the body.

A study of HIV-positive patients suggests that the interaction of the three drugs in the cocktail causes fat to collect in the patient’s abdominal area. It may also lead to weight loss in the arms, legs and face.

In addition, the drugs may interfere with certain proteins that are involved in controlling the body’s absorption of blood sugar. This could lead to the development of diabetes. ART is associated with insulin resistance, which is commonly the cause of type 2 diabetes.

Studies show that five to twenty percent of patients on protease-inhibitor-based ART will develop insulin resistance. About one to five percent actually has diabetes.

It's likely that people who already have diabetes and then go on ART may have greater difficulties in controlling their diabetes. This could lead to an increase in the risk of heart disease and other diabetes-related complications.

It's thought that patients who have both HIV and diabetes can continue to do well for many years, as long as they have access to good care. They should also keep their diabetes under control by following a healthy diet and exercising regularly.

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