Clinical Manual for Management of the HIV-Infected ... - myCME.com

Patient Education
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Antiretroviral therapy can increase the risk of
diabetes in some individuals. Patients should report
any difficulty with excessive hunger and thirst and
increased urination. Health care providers will
monitor blood glucose when doing laboratory work,
but it is important for the patient to call if any
symptoms are present.
Review exercise possibilities to determine what
activities might be realistic and acceptable for the
patient.
Review the patient’s eating habits and explain the
need to work with a dietitian to keep blood glucose
(and triglycerides) within normal limits. A proper
diet can reduce the risk of permanent damage to the
blood vessels of the eye, the kidney, the brain, and
can reduce the risk of a heart attack.
Emphasize other lifestyle modifications, such as
weight loss (if appropriate).
Provide medication-specific education, especially if
the patient will be taking metformin or insulin.
Consider referral to a diabetic clinic for specialty
needs.
Section 4—Complications of Antiretroviral Therapy | 4–15
References
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Dube MP, Stein JH, Aberg JA, et al. Guidelines
for the evaluation and management of dyslipidemia in
human immunodeficiency virus (HIV)-infected adults
receiving antiretroviral therapy: recommendations of
the HIV Medical Association of the Infectious Disease
Society of America and the Adult AIDS Clinical Trials
Group. Clin Infect Dis. 2003 Sep 1;37(5):613-27.
Hardy H, Esch LD, Morse GD. Glucose disorders
associated with HIV and its drug therapy. Ann
Pharmacother. 2001 Mar;35(3):343-51.
Schambelan M, Benson CA, Carr A, et al.
Management of metabolic complications associated
with antiretroviral therapy for HIV-1 infection:
recommendations of an International AIDS Society-
USA panel. J Acquir Immune Defic Syndr. 2002
Nov 1;31(3):257-75.
U.S. Department of Health and Human Services.
Guidelines for the Use of Antiretroviral Agents in HIV-
1-Infected Adults and Adolescents. October 10, 2006.
Available online at aidsinfo.nih.gov/Guidelines/
GuidelineDetail.aspx?GuidelineID=7. Accessed
July 7, 2007.
Wlodarczyk D. Managing Medical Conditions
Associated with Cardiac Risk in Patients with HIV.
In: Peiperl L, Volberding PA, eds. HIV InSite
Knowledge Base [textbook online]; San Francisco:
UCSF Center for HIV Information; August 2004.
Accessed February 7, 2006.