Lipodystrophy syndrome(s)

November 2001     View PDF     En español

Diabetes

Changes in insulin sensitivity may, in some cases, put people at higher risk for diabetes. Several small studies report some success in combating insulin resistance associated with protease inhibitor use. These include times when people stopped using protease inhibitors and switched to regimens with either abacavir (Ziagen) or nevirapine (Viramune).

Among those who used protease inhibitors, taking troglitazone (Rezulin) seemed to increase insulin sensitivity. Two recently approved drugs, rosiglitazone (Avandia) and pioglitazone (Actos), are likely to have the same effect with perhaps a lower risk of the serious liver side effects associated with troglitazone.

Another drug that restores insulin sensitivity is metformin (Glucophage). However, one possible and potentially fatal side effect of using it is lactic acidosis, a buildup of lactate in the body. Nucleoside analogue drugs that contribute to mitochondrial toxicity, like AZT, ddI and d4T, etc. can also cause lactic acidosis. (Read more about lactic acidosis in Project Inform’s publication, Mitochondrial Toxicity.)