Side Effects of HIV Medicines

Diabetes is a disease that develops when levels of blood glucose (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is the body’s main source of energy.

Over time, diabetes can cause serious health problems, including heart disease, stroke, kidney disease, eye problems, and nerve damage.

There are different types of diabetes: type 1, type 2, and gestational. This fact sheet discusses type 2 diabetes, which is the most common type of diabetes.

People at an increased risk of type 2 diabetes include those who:

• Are 45 years of age or older
• Have a family history of diabetes
• Are overweight or obese
• Do not engage in regular physical activity
• Are African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander American

People with HIV have additional unique risk factors for developing diabetes. Risk factors for diabetes in people with HIV include:

• Taking specific HIV medicines, including older-generation drugs (such as ritonavir)
• Having lipodystrophy
• Having hepatitis C 
• Having HIV-related inflammation

If you have HIV and any of the risk factors above, it is important to be aware of potential symptoms of diabetes.

Diabetes is associated with many symptoms which include:

• Increased thirst
• Frequent urination 
• Increased hunger 
• Unusual weight loss 
• Fatigue  
• Blurred vision 
• Tingling or numbness in the hands or feet
• Sores that do not heal

If you have HIV and are experiencing any of these symptoms, be sure to consult your health care provider to protect yourself from diabetes or other harmful conditions.

You should have your blood glucose levels checked before starting treatment with HIV medicines. Some HIV medicines should be avoided by people with high blood glucose levels.

Even if you don’t have diabetes, your health care provider may want to regularly check your blood glucose to make sure it stays at a healthy level.

You can take the following steps to prevent, delay, or manage type 2 diabetes:

• Maintain a healthy weight. If you are overweight, lose weight and keep it off.
• Eat healthily. Eat a variety of healthy foods (see MyPlate.gov for recommendations) and limit foods high in fat, sugar, and salt.
• Keep moving. Aim to get in at least 30 minutes of physical activity on most days of the week.

In addition to the above measures, some medicines can help manage type 2 diabetes. To learn more, visit the Managing Diabetes webpage from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

If you have HIV, talk to your health care provider about your risk for diabetes and what you can do to protect your health. The best way to reduce your risk of diabetes is to take care of yourself by maintaining a proper diet, exercising regularly, and taking your HIV medicines as prescribed. 

From the NIH Office of AIDS Research:

• Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV: 
  • Adverse Effects of Antiretroviral Agents
  • Laboratory Testing for Initial Assessment and Monitoring of People With HIV Receiving Antiretroviral Therapy 
  • Poor CD4 Cell Recovery and Persistent Inflammation Despite Viral Suppression

From the U.S. Department of Agriculture:

• MyPlate

From the U.S. Department of Veterans Affairs: 

• Primary Care of Veterans with HIV: Diabetes Mellitus

From NIDDK: 

• Diabetes Overview

From the National Library of Medicine:

• Diabetes in People Living with HIV. [Updated 2023 Nov 1]. Sarkar S., and Brown T.T. In: Feingold K.R., Anawalt B., Blackman M.R., et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK545886/

Also see the HIV Source for a collection of HIV links and resources.