Abstract:
OBJECTIVE:To describe a glucose abnormality in AIDS that is characterized by transient NIDDM followed by hyperinsulinemic normoglycemia. RESEARCH DESIGN AND METHODS:A 36-yr-old Hispanic man with AIDS was on long-standing aerosolized pentamidine therapy in 1986. He received a course of intravenous pentamidine 5 mo before the onset of diabetes. Nonketotic hyperglycemia responded to sulfonylurea, which had to be discontinued 3 mo later because of normoglycemia. RESULTS:Diabetes diagnosis was made by three separate fasting blood glucose values of 16.2, 18.1, and 29.9 mM, and HbA1C of 10.1% (normal 4.2-5.9). The patient became euglycemic 5 mo after diagnosis while on no treatment. An oral glucose tolerance test was then normal, and C-peptide stimulation showed supra-normal response. CONCLUSIONS:Transient severe NIDDM in this case could not be linked to acute stress. Pentamidine, in a progressively increasing cumulative dose, is one possible, albeit unusual, etiology because the diabetes was not permanent. After diabetes remission, the data suggest residual insulin resistance that is unusual in HIV-positive patients. Diverse glucose abnormalities exist in AIDS. Awareness of their presentation is clinically helpful.
journal_name
Diabetes Carejournal_title
Diabetes careauthors
Abourizk NN,Lyons RW,Madden GMdoi
10.2337/diacare.16.6.931subject
Has Abstractpub_date
1993-06-01 00:00:00pages
931-3issue
6eissn
0149-5992issn
1935-5548journal_volume
16pub_type
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