Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.
The Associated Press - September 19, 2000
Emma Ross
In the last few years, scientists have reported seeing HIV patients with diabetes who also have a condition where fat collects in their abdomens while their faces and limbs become abnormally thin. They have suspected that recently developed AIDS drugs called protease inhibitors might be linked to both problems.
However, Dr. Eric Renard told a conference of the European Association for the Study of Diabetes that his research on 102 HIV patients showed that the two conditions were in fact related to three separate medications in a cocktail of HIV drugs.
Known as anti-retrovirals, these drugs have been credited with contributing to the dramatic drop in AIDS deaths seen over the last few years.
Renard, a professor of medicine at Montpelier University in France, said the fat problem was linked to two of the drugs in the cocktail, D4T and 3TC. He said diabetes appeared to be triggered by the third type of drug, protease inhibitors, but only in patients who already had the fat problem.
Dr. Olga Vaccaro of the department of clinical and experimental medicine at Federico II University in Naples, Italy, said Renard's research could help scientists better understand this rare type of diabetes and offered an interesting theory of what caused it.
"But it is difficult to separate the effects of one drug from another because HIV patients have been on multiple treatments," she said.
She said if a link between diabetes and the HIV treatment is confirmed, doctors may have to take this into consideration when treating HIV patients.
Renard said the development of diabetes in HIV patients may be linked to the fact that those drugs have been found to interfere with the ability of a protein that is responsible for taking sugar from the blood into muscles, the liver and other tissues.
Insulin is a hormone that escorts sugar through the blood stream and "unlocks" tissues so that the sugar can enter. In diabetics, insulin cannot do its job properly and too much sugar remains in the blood.
"We now understand why protease inhibitors may introduce diabetes in these patients," Renard said. "They will probably never die of AIDS, so now the problem is if you are stabilized on one disease, will you get another one?"
In the study, 89 of the 102 patients had the fat distribution problem. Of those, 74 were taking protease inhibitors. Diabetes then developed in 13 percent of those patients and a precursor for diabetes, a problem disposing of blood sugar, developed in another 19 percent.
Only 7 percent of the 15 people not taking the drugs developed the blood sugar disposal problem, while none of them got diabetes.
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