ABSTRACT
PURPOSE: To discuss the pathophysiology and the current treatment approaches for the dysregulation of glucose metabolism in the context of human immunodeficiency virus (HIV) infection. DATA SOURCES: Selected research, clinical studies, clinical guidelines, and review articles. CONCLUSIONS: In HIV infection, multiple factors are associated with the pathogenesis of glucose dysregulation. Studies suggest that protease inhibitors, a class of antiretroviral agent, as well as viral factors, lipodystrophy, hepatitis C infection, injection drug use, and second-generation antipsychotics have been implicated in the development of glucose disorders and diabetes. Current treatment recommendations are based on extrapolated data from non-HIV diabetic patients. More research is needed to establish the most appropriate management for the disorders of glucose metabolism in the context of HIV infection. IMPLICATIONS FOR PRACTICE: If left untreated, patients are at increased risk for cardiovascular disease and complications associated with untreated diabetes.
Subject(s)
Diabetes Mellitus/virology , HIV Infections/complications , Algorithms , Anti-HIV Agents/adverse effects , Antidepressive Agents, Second-Generation/adverse effects , Antiretroviral Therapy, Highly Active/adverse effects , Cardiovascular Diseases/etiology , Comorbidity , Decision Trees , Diabetes Mellitus/diagnosis , Diabetes Mellitus/metabolism , Diabetes Mellitus/prevention & control , Feeding Behavior , HIV Infections/drug therapy , HIV Protease Inhibitors/adverse effects , HIV-Associated Lipodystrophy Syndrome/complications , HIV-Associated Lipodystrophy Syndrome/virology , Hepatitis C/complications , Humans , Hypoglycemic Agents/therapeutic use , Insulin Resistance , Life Style , Nursing Assessment , Practice Guidelines as Topic , Risk Factors , Risk Reduction Behavior , Substance Abuse, Intravenous/complicationsABSTRACT
NYU MAINSTREAM fellows collaborated with a student health center. An objective structured clinical evaluation (OSCE) was conducted by the fellows for the center's personnel.
