Could Zerit effect on Type II diabetes
Apr 13, 2005
I was diagnosed with AIDS in July 03 while in hospital for severe pneumonia. My VL was ~60,000 and CD4 was 3. I was put on Combivir and Kalentra with good initial results; VL dropped to <50 and CD4 began to slowly rise. I was already a Type II diabetic (I am 55) managing well on 1000 mg Metformin x2 and a (semi)low-carb diet. After leaving the hospital I was able to reduce the dose to half that, because of, I suspect, all the weight I had lost. At about the six month mark, I began to experience anemia whch quickly became serious, requiring tranfusions. My AIDS specialist switched me off the Combivirr to Zerit + Epivir; i.e., replacing the AZT in Combinvir with Zerit. The anemia cleared up although the red blood counts are still slightly off. However, shortly after the switch my diabetes problems increased; soon I was back on the maximum dose of Metformin, and then that plus another oral agent. To no good effect: I was soon on insulin. My native insulin production seems to have stopped. Before this I had good control; fasting glucose levels usually under 100 and long term at or under 5%, and I had only regained about 10 lbs from my hospital low weight. My initial experience on insulin was OK, but I am beginning to have problems which I will not detail here. Is there any database, any experience on the possible interrealtions between hiv/AIDS, its medications, and diabetes? My regular doctor and the AIDS specialist haven't been able to help and seem to feel that a successful anti-AIDS program should be continued, since the diabetes can be otherwise controlled. I actually tend to agree with that, but I don't really know. Any knowledge would be greatly appreciated. Thank you.
Response from Dr. Henry
Zerit (D4T) has been linked to fat/lipid abnormalites though general not as much related to glucose problems. The metabolic disturbances seen with Zerit could potentially aggravate a diabetic state. Often a different drug such as abacavir (Ziagen) or tenofovir (Viread) might be considered and a swtich made with careful observation. KH
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