Iwata Kentaro, Ogawa Wataru
Division of Infectious Diseases, Department of Microbiology and Infectious Diseases, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuo-ku, Kobe, Hyogo, 650-0017, Japan.
Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
J Med Case Rep. 2017 Jun 14;11(1):157. doi: 10.1186/s13256-017-1326-z.
With the advent of effective antiretroviral therapy, the care of patients with human immunodeficiency virus infection became more like that of other chronic diseases. Diabetes mellitus can also occur as one of the chronic illnesses affecting patients with human immunodeficiency virus infection. We report a case of newly developed diabetes mellitus in a patient with human immunodeficiency virus infection, most likely caused by the nucleoside analogue zidovudine, and its improvement after discontinuation of zidovudine.
A Chinese man in his 30s visited our outpatient clinic for routine follow-up of human immunodeficiency virus infection. Blood tests showed hyperglycemia with a glucose level of 31.8 mmol/L and hemoglobin A1c of 8.5%. He was diagnosed with diabetes mellitus and treated with oral diabetic medications. The use of zidovudine was suspected as the cause of his diabetes, and it was replaced by other antiretroviral medication. His hyperglycemia improved, and he now no longer requires diabetic medications.
Diabetes mellitus can develop with the use of antiretroviral medications, but its occurrence associated with use of zidovudine is quite rare. Healthcare personnel should be aware of this rare, yet important, side effect.
随着有效抗逆转录病毒疗法的出现，人类免疫缺陷病毒感染患者的护理变得更类似于其他慢性病的护理。糖尿病也可能作为影响人类免疫缺陷病毒感染患者的慢性病之一出现。我们报告了一例人类免疫缺陷病毒感染患者新发生的糖尿病病例，最有可能由核苷类似物齐多夫定引起，停用齐多夫定后病情改善。
一名30多岁的中国男性到我们门诊进行人类免疫缺陷病毒感染的常规随访。血液检查显示血糖升高，血糖水平为31.8 mmol/L，糖化血红蛋白为8.5%。他被诊断为糖尿病，并接受口服降糖药物治疗。怀疑他的糖尿病是由齐多夫定引起的，于是将其替换为其他抗逆转录病毒药物。他的高血糖情况有所改善，现在不再需要降糖药物。
使用抗逆转录病毒药物可能会引发糖尿病，但其与齐多夫定使用相关的情况相当罕见。医护人员应意识到这种罕见但重要的副作用。
