Notes from the Underground

(NOTES) One Lump or Two

NOTES FROM THE UNDERGROUND; PWA Health Group - July, 1997
Halley Low

The FDA has issued an important notice to all people taking, or considering taking, any of the four approved protease inhibitors. For unknown reasons, protease inhibitors may cause diabetes or hyperglycemia (elevated blood sugar levels). As of May 12, eighty three cases of diabetes/hyperglycemia had been reported to the FDA. These are only the reported cases as of that date. (We at the Health Group know of other cases not yet reported.)

Diabetes and hyperglycemia are serious. If unrecognized and untreated they can lead to coma and death. What are the main symptoms? Fruity-smelling breath, excessive thirst, excessive hunger, increased urination (peeing), fatigue, sudden weight loss, and dry-itchy skin. If you are taking protease inhibitors and are experiencing any of these symptoms, see your doctor immediately!!! If you are taking protease inhibitors and are not experiencing these symptoms, discuss this important matter with your doctor, and have your blood sugar level checked to be on the safe side. It seems to happen most often between 2 and 3 months of starting therapy.

You ask: if the FDA knew about 83 cases by May 12th, why did they wait until June 17th to release the information? How many more cases have been reported to them since May 12th? It might have been wise for the new anti-viral guidelines to call for routine testing of blood sugar levels for people on combination therapy. Apparently they didn't think so.

In a related letter published in the June 14th issue of Lancet (a British medical journal), two California doctors reported that two of their patients have developed "acute pancreatitis and acute renal (kidney) failure in conjunction with combination therapy". Pancreatitis is an inflammation of the pancreas, the organ that produces insulin which our bodies use to break down sugar during digestion. Pancreatitis is characterized by severe abdominal pain, can damage the pancreas, and can lead to diabetes. Fortunately for those two patients, combination therapy was stopped, and in time they recovered. Their doctors think it is important for all doctors treating people with HIV to be aware of this potentially life-threatening complication. We think patients should also be aware.

Following on the heels of the California doctors, comes a study from the National Institute of Diabetes, Digestive and Kidney Diseases. It reports that Indinavir (aka Crixivan) can cause "crystal formations" in the kidney and bladder, which can cause painful urination, kidney stones, and possible renal failure. Twenty precent of 142 people tested showed evidence of abnormal crystal formation. It was reported that "increasing fluid intake" (drinking more water) helped some people in the study, because it flushed out the kidneys. Others had to be taken off Crixivan. Concern was expressed that doctors may misdiagnosis flank pain and/or painful urination as signs of infection, and incorrectly treat with antibiotics. If you are taking Crixivan be sure to discuss this with your doctor, and act like a sponge and soak up the water.
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Always watch for outdated information. This article first appeard in 1997. This material is designed to support, not replace, the relationship that exists between you and your doctor.

Copyright © 1997 - NOTES FROM THE UNDERGROUND - The PWA Health Group Newsletter. All rights reserved. No part of this publication may be copied or reproduced in any form or by any means without the written permission from the PWA Health Group. NOTE: The PWA Health Group is no longer in existence, as per notification in 2003. An organization called Visionary Health Concepts has succeded them. VHConcepts is a HIV/Hepatitis+ owned and operated health education company specializing in providing free HIV & Hepatitis treatment programs For more information please contact Email: edu@vhconcepts.com. .

This information is designed to support, not replace, the relationship that exists between you and your doctor.
©1997. ÆGIS.