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When Steve Craftman, 55, (left) developed Type 2 in 2007, he knew exactly what had caused it – the early antiretroviral medicines he took to treat his HIV. As he tells balance, it was the price he had to pay to stay alive
HIV, diabetes & me
W
hen my little brother was diagnosed with Type 1 in the early 1980s, I knew very little about diabetes. There was no family history of the condition, and once he had it under control, the subject rarely came up. It never crossed my mind that, 25 years later, I’d develop diabetes too. Back then I also knew very little about human immunodeficiency virus (HIV) – identified in 1981 as the virus that can cause Aids – nobody really did. In 1986, I heard that a man I’d had a fling with the year before had died of an Aidsrelated illness and I thought, ‘well, if I didn’t have it before, I’ve sure got it now’. I had the test and, as I expected, it was positive. Like many gay men at that time, I felt resigned to the news. Received wisdom was that you had about five years left to live once you were diagnosed. The key thing became
stopping others from getting it while looking after ‘our own’.
Experimental medicine In the knowledge that there was apparently nothing that could stop HIV wrecking our immune systems, we learned to clutch at straws. Often the patients knew as much as or more than the doctors. Nobody knew the correct doses of the antiretroviral drugs that were slowly being discovered, and many of us were overdosing on these toxic drugs. By 1998, I’d been through pretty much every drug available and had lived way past my ‘dead-by date’. I then started on a new class of drugs: protease inhibitors. I was warned that research showed all protease inhibitors, while effective against HIV, had the side effect of causing metabolic changes, especially hyperlipidaemia (high levels of blood fats) and hypergylcaemia (high blood glucose). But who cared?
Diabetes, heart disease, high blood pressure, lipodystrophy (changes in body shape) and the rest were better than your own funeral. The following year my cholesterol level started to climb, but so did my CD4 count (at the time this was considered the most important figure in assessing how well a drug was working). Even though the drugs made me feel ill and put me at risk of diabetes and high blood pressure, I stuck with them because they were doing some good.
Life changes In 2003, my partner, John, discovered that he had a longstanding HIV infection. He was already very ill and died in the spring of 2007. After four years as John’s sole carer, I wanted not to have to remember things, to sleep around the clock if I felt like it, so I immediately went on a treatment ‘holiday’. For the drugs to work, you
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January – February 2012 balance 29 28-31 Feat HIV KFfinal.indd 29
10/01/2012 12:31