• ARVs are associated with increased metabolic dysfunction, including insulin resistance, dyslipidemia and lipodystrophy
• Protease inhibitors (PIs) increase insulin resistance and reduce insulin secretion by interfering with GLUT–4 mediated glucose transport
• Standards of treatment and management of diabetes for patients with HIV are generally the same as those for diabetic patients without HIV and patients who acquire HIV may continue to be managed with the same drug therapy as before
• Sulfonylureas may not be effective in the face of severe insulin resistance. In case glycemic control deteriorates, insulin should be initiated, rather than increasing dosage or number of oral medications People who are on ARTs need to be screened for diabetes at least once a year and especially if they have other CVD risk factors