Beneficial effects of telmisartan in an HIV+ diabetic insulin-dependent patient

In HIV-infected patients with metabolic disorders, as in the general population, there is evidence of hypertension requiring pharmacological treatment. The presence of diabetes constitutes a cluster of particularly high cardiovascular risks in patients, both regarding diabetic damage and hypertensive damage. We used telmisartan to manage high blood pressure values in an HIV-positive patient with insulin-dependent diabetes. Surprisingly, insulin therapy had to be suspended because of hypoglycemic fits and treatment with metformin was started. In conclusion, telmisartan was effective and well tolerated for the control of hypertension in this case and improved sensitivity to insulin. There are interesting effects of this drug in HIV-positive diabetic patients. Thus, if further studies confirm these effects, telmisartan may be the anti-hypertensive drug of first choice in HIV-infected subjects on combined antiretroviral therapy affected with diabetes and metabolic disorders.