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Hyperglycemia After Dolutegravir-Based Antiretroviral Therapy
Workagegnehu Hailu1, Tsebaot Tesfaye1, Abilo Tadesse1
1Department of Internal Medicine, University of Gondar, Gondar, North Gondar, Ethiopia.
International Medical Case Reports Journal
|August 5, 2021
Summary
New-onset diabetes mellitus occurred in HIV patients after switching to a dolutegravir (DTG)-based regimen. Monitoring plasma glucose is recommended for patients on DTG-based antiretroviral therapy.
Area of Science:
- Infectious Diseases
- Endocrinology
- Pharmacology
Background:
- Antiretroviral therapy (ART) significantly improves outcomes for HIV-infected individuals.
- While beneficial, ART can cause adverse effects, including metabolic complications.
- This report focuses on new-onset diabetes mellitus linked to dolutegravir-based ART.
Observation:
- Patients previously on NNRTI-based ART were switched to dolutegravir (DTG)-based ART.
- New-onset diabetes mellitus, with or without diabetic ketoacidosis, was diagnosed 1-12 months post-DTG initiation.
- Symptoms included polyuria, polydipsia, fatigue, and severe hyperglycemia (>250 mg/dl).
Findings:
- Two patients with DKA were treated with IV fluids, regular insulin, and later metformin.
- One patient with severe hyperglycemia received NPH insulin, then metformin.
- Metformin achieved good glycemic control while DTG-based ART continued.
Implications:
- Hyperglycemia is a potential side effect of dolutegravir-based ART regimens.
- Baseline and periodic plasma glucose monitoring may be necessary for patients on DTG.
- This highlights the importance of metabolic monitoring in HIV management.
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