Diabetes, protease-inhibitor link unproved: directorate
CMAJ 1997;157:502
© 1997 Canadian Medical Association
The Therapeutic Drugs Directorate at Health Canada says there is no conclusive evidence that protease inhibitors cause diabetes and hyperglycemia in HIV-infected patients but it recommends that physicians proceed cautiously until more information is available.
Although there have been reports that 8 Canadian patients, and 152 patients worldwide, have developed onset diabetes mellitus or exacerbated existing diabetes mellitus while receiving protease inhibitors, the directorate said "there is no conclusive evidence to establish a causal relationship." In a letter sent to CMAJ in July, the directorate said many of the reports involved patients with confounding medical conditions, some of which required treatment with agents that have been associated with the development of diabetes mellitus or hyperglycemia. It says HIV-infected patients who are currently using protease inhibitors should not necessarily discontinue therapy but should consult their physician. Physicians are advised to weigh the severity of the diabetes and hyperglycemia against the known benefits of protease inhibitors.
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