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impaired trolerance
May 28, 2003

Hi, I'm looking to be proactive with regards to blood glucose levels, in the same way we are now agressive in lowering cholesterol and bp.Is this a good idea? Here are my facts:

Hiv + 12 yrs. NO meds since may 2001.Current cd4 651(31) and vl 19,400 asymptomatic.

Since I went off meds my glucose has been betw 92-118. Recently it's been 117 and 118. I had a 3 spec gluc toler. test a few days ago.REsults are fasting 117,1 hour 199,2 hour 155.(Quest 2hr ref range of 140-199=impaired tolerance. I have some facial wasting and a small hump,(zerit) Would it be a thought to try something like troglitazone or the other med to lower glucose level and try tro improve lipostrophy? MY ht is 6tfeet wt is 220.I swim 3-4x a week but cannot seem to loose wt.( I cannot run anymore bec of bad hips.ANy thoughts what my next step should be?( My chol is normal LIpitor 40 mg(141,ldl=79,hdl=46 and my test is low end of normal,total=297,free=92 and free/weakly=185. Sincerely,Luke

Response from Dr. Boyle

There are currently no data that indicate that aggressive treatment of your glucose or lipodystrophy are appropriate. Unfortunately, studies have yet to show that there are any effective treatments for lipodystrophy, except human growth hormone, which may make your hump better, but your facial wasting and glucose levels worse. You should discuss your options with your doctor, but seeing a nutritionist regarding exercise and diet advice might be helpful.

Liquid and VidexEC
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