AEGiS-ATDN: Update on Protease Inhibitors and Diabetes

Important note: Information in this article was accurate in 2000. The state of the art may have changed since the publication date.

Update on Protease Inhibitors and Diabetes

Information Bulletin #11 June/July 2000

Protease inhibitors are a group of anti-HIV drugs that currently includes Agenerase, Crixivan, Fortovase, Norvir and Viracept. Shortly after the first of these drugs were approved, the US Food and Drug Administration received reports that they might be associated with the development of diabetes (severe problems with sugar processing in the body) in some people. Since that time, relatively few cases of diabetes have been documented among people taking protease inhibitors. However, there have been many reports of a milder problem with sugar processing called insulin resistance.

A new study has found a mechanism by which protease inhibitors may cause this side effect. There is a system for transporting sugar to cells in the body that protease inhibitors were found to block. This study highlights the importance of regular monitoring for insulin resistance in people taking protease inhibitors. The researchers who conducted the study also suggested that this problem may be related to the condition called lipodystrophy (a general name for loss of fat tissue from the face, arms and legs, sometimes with fat build up around the waist). Further studies are needed before it can be certain that the effect of protease inhibitors on sugar processing is related to lipodystrophy.

The full name of this study is "The Mechanism of Insulin Resistance Caused by HIV Protease Inhibitor Therapy" by Haruhiko Murata, Paul W. Hruz, and Mike Mueckler. The study was published in the Journal of Biological Chemistry, Vol. 275, Issue 27, 20251-20254, July 7, 2000. A technical summary of the study can be read on the internet at: http://www.jbc.org/cgi/content/abstract/275/27/20251. The full manuscript of the study can also be downloaded free of charge at: http://www.jbc.org/cgi/reprint/C000228200v1.pdf
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