|
|
 |
|
| •
|
Diet,
exercise, and weight reduction (if needed) |
| •
|
Same
treatment as for HIV-negative patients |
| •
|
Optimal
management of impaired glucose tolerance (2-hour glu >140
mg/dL and < 200 mg/dL) is not known |
| •
|
Switch
ARV regimen |
| •
|
Insulin
sensitizing agents:
|
|
-
|
Biguanides
|
|
-
|
Glitazones |
|
-
|
Metformin |
| •
|
No
role for sulfonylureas and similar agents
|
• Patients with HIV infection and diabetes mellitus should be
treated in the same manner as diabetic patients without HIV. This
includes initial interventions with diet, exercise, and weight reduction,
if needed.
• It should be noted, however, that we still do not know how
to optimally manage patients with insulin resistance.
• As with the fat redistribution syndromes, switching antiretroviral
regimens by removing an offending agent may offer some help in curtailing
these abnormalities.
• Insulin-sensitizing agents, such as the biguanides and the
glitazones, can be successfully used in patients with HIV infection.
• However, there is no role for the sulfonylureas and similar
agents when treating these individuals.
|
|
|
|
