{"id":2861,"date":"2006-12-06T23:06:01","date_gmt":"2006-12-06T22:06:01","guid":{"rendered":"http:\/\/moomango.co.uk\/htb\/?p=2861"},"modified":"2013-12-06T15:19:16","modified_gmt":"2013-12-06T15:19:16","slug":"d4t-associated-with-significantly-increased-risk-of-type-2-diabetes-mellitus","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/2861","title":{"rendered":"d4T associated with significantly increased risk of type-2 diabetes mellitus"},"content":{"rendered":"<p><strong>Simon Collins, HIV i-Base<\/strong><\/p>\n<p><strong>The use of d4T (stavudine) has dramatically fallen in most Western countries, primarily due to high risk of lipoatrophy, and additive mitochondrial-related toxicity with other reverse transcriptase inhibitors. However, globally it remains one of the most widely ARVs prescribed first line therapy (in d4T\/3TC\/nevirapine), as the basis for the least expensive WHO-recommended fixed dose combinations (FDCs).<\/strong><\/p>\n<p>Further caution against use of d4T as a long-term treatment option was highlighted in an analysis of the use of d4T and the risk of diabetes mellitus (DM) from the D:A:D Study, given in an oral presentation by Stephane de Wit<\/p>\n<p>D:A:D is a prospective observational study of 23,437 HIV patients that has a focus on toxicity and safety issues relating to ARV treatment, including lipodystophy, cardiovascular risk and heaptotoxicity and where DM is collected as a study endpoint.<\/p>\n<p>The incidence of diabetes mellitus (DM) in the D:A:D study is comparable to that in HIV-negative populations, and this analysis aimed to identify whether specific antiretrovirals (ARV) were associated with new onset DM.<\/p>\n<p>However, the rate of DM (\/1000 PY) increased from 3.96 in those unexposed to d4T to 8.20 in those exposed for 2-3 years and then decreased. No other ARV was significantly associated with DM after controlling for d4T use.<\/p>\n<p>Time-updated total cholesterol, HDL-cholesterol and triglycerides were all associated with DM. Adjusting for each of these separately reduced slightly the relationship between d4T and DM. While lipodystrophy was significantly associated with DM (1.37, p=0.008), adjustment for this did not modify the relationship between d4T and DM. This led the authors to conclude that \u0091d4T potentially directly contributes to insulin resistance, rather than through lipodystrophy\u0092.<\/p>\n<p class=\"ref\">Reference:<\/p>\n<p class=\"ref\">De Wit S, Sabin CA, Weber R et al. Relationship between use of stavudine and diabetes mellitus. 8th International Congress on Drug Therapy in HIV Infection, 12-16 November 2006, Glasgow. Oral abstract PL9.5.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Simon Collins, HIV i-Base The use of d4T (stavudine) has dramatically fallen in most Western countries, primarily due to high risk of lipoatrophy, and additive mitochondrial-related toxicity with other reverse transcriptase inhibitors. However, globally it remains one of the most &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8,27],"tags":[84],"class_list":["post-2861","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-side-effects","category-weight-diabetes-metabolic-complications","tag-hiv-8-glasgow-2006"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2861","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=2861"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/2861\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=2861"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=2861"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=2861"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}