Protease inhibitors, diabetes mellitus and blood lipids

We report the case of a patient with human immunodeficiency virus (HIV) and no familial or personal history of metabolic disease, who experienced two diabetes decompensations (severe hyperglycaemia without ketonuria) associated with severe hypertriglyceridaemia, after the introduction of protease inhibitors. Initial insulin therapy at high doses (2 IU/kg/day) was required, and metabolic control was restored within several weeks without treatment after withdrawal of protease inhibitors. This case confirms that due attention must be paid to both blood glucose and plasma triglyceride levels in HIV-infected patients treated with protease inhibitors.