Insulin resistance, glucose intolerance and diabetes mellitus in HIV-infected patients

Antivir Ther. 2007;12(2):149-62. doi: 10.1177/135965350701200214.


An increased prevalence of insulin resistance, glucose intolerance and diabetes has been reported in HIV infection in the highly active antiretroviral therapy (HAART) era. This development might be clinically significant because of its association with cardiovascular morbidity and mortality as well as the therapeutic challenges of managing polypharmacy. The development of insulin resistance, glucose intolerance and diabetes could be related to the underlying HIV infection, the contribution of different antiretroviral agents, treatment-associated weight gain, immune restoration, as well as the non-HIV related factors. Dissecting these factors in clinical practice might be difficult. Clinical studies include short-term treatments in healthy, non-HIV-infected individuals; randomized, controlled trials; comparative studies of different HAART regimens; and randomized studies of switching regimens in patients with viral suppression and stable immune function. This article reviews the latest knowledge regarding the epidemiology, pathogenesis, prevention and treatment of insulin resistance, glucose intolerance and diabetes mellitus in HIV-infected individuals.

Publication types

  • Review

MeSH terms

  • Anti-Retroviral Agents / adverse effects*
  • Antiretroviral Therapy, Highly Active
  • Diabetes Mellitus / chemically induced
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / etiology*
  • Diabetes Mellitus / physiopathology
  • Glucose Intolerance / chemically induced
  • Glucose Intolerance / drug therapy
  • Glucose Intolerance / etiology*
  • Glucose Intolerance / physiopathology
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • HIV Infections / physiopathology
  • HIV-Associated Lipodystrophy Syndrome / etiology
  • HIV-Associated Lipodystrophy Syndrome / physiopathology
  • Humans
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance*
  • Prevalence


  • Anti-Retroviral Agents
  • Hypoglycemic Agents