Transient State of NIDDM in a Patient With AIDS
| Autor: | Nicolas Abourizk, Gayle M. Madden, Robert W. Lyons |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastroenterology chemistry.chemical_compound Insulin resistance Internal medicine Diabetes mellitus Glyburide Internal Medicine medicine Hyperinsulinemia Humans Insulin Pentamidine Advanced and Specialized Nursing Acquired Immunodeficiency Syndrome Glucose tolerance test AIDS-Related Opportunistic Infections C-Peptide medicine.diagnostic_test Cumulative dose C-peptide business.industry Glucose Tolerance Test Glucagon medicine.disease Endocrinology Diabetes Mellitus Type 2 chemistry business Proinsulin medicine.drug |
| Zdroj: | Diabetes Care. 16:931-933 |
| ISSN: | 1935-5548 0149-5992 |
| DOI: | 10.2337/diacare.16.6.931 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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