Does ART cause hyperglycemia and diabetes?
Although several studies have shown that PIs can have a direct effect on glucose metabolism, predominantly by increasing insulin resistance, it remains unclear whether ART significantly increases the risk for developing diabetes mellitus. Available data would suggest that ART, particularly with PIs, likely causes a slightly increased risk of developing overt diabetes mellitus. Routine monitoring for hyperglycemia is recommended for any patient on a PI-based regimen (see Table 6-3). Studies of patients with hyperglycemia and insulin resistance have consistently shown that switching from a PI to either nevirapine (NVP), efavirenz (EFV), or abacavir (ABC) will significantly improve the hyperglycemia and insulin resistance. Nevertheless, further study is needed to better clarify the risk of a patient’s developing diabetes mellitus while taking a PI and the long-term clinical benefit of switching from a PI to a regimen that causes less insulin resistance. Does ART cause abnormalities in bon
