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Insulin-Requiring Diabetes Mellitus Associated with Pentamidine Therapy in a Patient with AIDS

From the School of Nursing, Penn State University, Harrisburg, Pennsylvania (Ms Maneval), and the Department of Nursing, Penn State University Hospital, Hershey, Pennsylvania (Ms Carrick). Correspondence to Rhonda E. Maneval, MSN, RN, C, 602 Eshleman Street, Highspire, PA 17034. Reprint requests to The Diabetes Educator, 500 North Michigan Avenue, Suite 1400, Chicago, IL 60611-3796. In January 1992, a male patient with acquired immunodeficiency syndrome (AIDS) was admitted to the hospital with a blood glucose level of 790 mg/dL (43.9 mmol/L). He was found to be in a nonketotic hyperosmolar hyperglycemic state, and subsequently was diagnosed with insulin-requiring diabetes mellitus. The patient was believed to have developed diabetes mellitus as a result of pentamidine therapy. The patient had received a 21day course of intravenous pentamidine isethionate therapy, as well as monthly treatments of aerosolized pentamidine. Prior to this experience, the diabetes management team had not encountered diabetes as a result of pentamidine drug therapy. Because of the lack of previ-