       Document 1065
 DOCN  M9621065
 TI    Effects of aerosolized pentamidine on glucose homeostasis and insulin
       secretion in HIV-positive patients: a controlled study.
 DT    9602
 AU    Uzzan B; Bentata M; Campos J; Mosnier A; Krivitzky A; Perret GY;
       Modigliani E; Department of Pharmacology-Hormonology, Avicenne Hospital,
       CHU; Paris-Nord, Bobigny, France.
 SO    AIDS. 1995 Aug;9(8):901-7. Unique Identifier : AIDSLINE MED/96014964
 AB    OBJECTIVE: Intravenous pentamidine induces hypo- and hyperglycaemia
       (dose-dependent toxicity on islet beta cells), pancreatitis and
       nephrotoxicity. Conversely, aerosolized pentamidine (AP) is usually
       devoid of systemic side-effects: few reports of hypo- or hyperglycaemia
       have been published. Our study aimed to assess the influence on glucose
       homeostasis and insulin secretion of long-term exposure to AP used for
       prophylaxis of Pneumocystis carinii pneumonia in HIV-positive patients,
       and to compare the impact on insulin secretion of AP, whether
       administered for the first time or after prolonged monthly exposure.
       DESIGN: Retrospective cross-sectional controlled study (main objective)
       and non-randomized prospective controlled study. PATIENTS: We compared
       glucose homeostasis and C peptide response to 1 mg intravenous glucagon
       in patients who had previously inhaled > or = 10 prophylactic aerosols
       (group 1, n = 21) and in HIV-positive controls (groups 2 and 3, n = 28)
       who had received none. Both groups were comparable for age and body-mass
       index, but CD4 T-lymphocyte counts and Karnofsky scores were both
       significantly higher in the control group. RESULTS: Fasting (T0) blood
       glucose, fructosamine and response to the first glucagon test were
       similar in both groups, but postprandial glucose, glycated haemoglobin
       and fasting C peptide were significantly higher (P < 0.05) in the
       pentamidine group. A second glucagon test was performed on the same day,
       3 h (T3) after AP inhalation in 35 patients (in 21 after > or = 10
       aerosols, group 1; in 14 after the first, group 2) and in 14
       HIV-positive controls (group 3). The only significant difference between
       the three groups in C peptide response to this second test was a lower
       peak T3/peak T0 ratio in group 1. Plasma amylase and creatinine were not
       altered by the aerosol. CONCLUSION: Long-term prophylactic exposure to
       AP had minor but significant effects on glucose homeostasis and insulin
       secretion but did not modify pancreatic and renal function. The
       detrimental effects induced by long-term exposure to AP found in our
       study are probably not clinically relevant, but a more prolonged
       exposure to AP might conceivably induce more severe alterations.
 DE    Administration, Inhalation  Adult  Aerosols  AIDS-Related Opportunistic
       Infections/PREVENTION & CONTROL  C-Peptide/BLOOD  Cross-Sectional
       Studies  Female  Glucose/*METABOLISM  Homeostasis/DRUG EFFECTS  Human
       HIV Infections/*DRUG THERAPY/PHYSIOPATHOLOGY  Insulin/*SECRETION  Islets
       of Langerhans/DRUG EFFECTS/PHYSIOPATHOLOGY  Male
       Pentamidine/*ADMINISTRATION & DOSAGE/*ADVERSE EFFECTS  Pneumonia,
       Pneumocystis carinii/PREVENTION & CONTROL  Prospective Studies
       Retrospective Studies  Time Factors  CLINICAL TRIAL  CONTROLLED CLINICAL
       TRIAL  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

