Diabetes mellitus and impaired fasting glucose in ART-naïve patients with HIV-1, HIV-2 and HIV-1/2 dual infection in Guinea-Bissau: a cross-sectional study

Abstract

Background: The prevalence of diabetes mellitus (DM) is expected to increase in sub-Saharan Africa. Patients with HIV are at particular risk. We investigated the DM burden among antiretroviral therapy (ART)-naïve patients with HIV in Guinea-Bissau.Methods: Patients were consecutively included. Demographic and lifestyle data were collected and one fasting blood glucose (FBG) measurement was used to diagnose DM (FBG≥7.0 mmol/L) and impaired fasting glucose (IFG) (FBG≥6.1 and ,7.0 mmol/L).Results: By June 2015, 953 newly diagnosed ART-naïve patients with HIV had been included in the study of whom 893 (93.7%) were fasting at the time of inclusion. Median age among the fasting patients was 37 years (IQR 30-46 years) and 562 (62.9%) were women. The prevalence of DM was 5.8% (52/893) while 5.6% (50/893) had IFG. DM was associated with family history of DM (OR 3.92, 95% CI 1.78 to 8.63), being 41-50 years (OR 2.98, 95% CI 1.18 to 7.49) or older than 50 years (OR 3.14, 95% CI 1.09 to 9.07) and Fula ethnicity (OR 2.72, 95% CI 1.12 to 6.62).Conclusions: DM prevalence was higher among younger patients compared with the background population in Bissau. Traditional risk factors for DM such as advancing age and a family history of DM apply also for ART-naïve patients with HIV.

Presence, patterns & predictors of hypocortisolism in patients with HIV infection in India

“…The occurrence of dysglycaemia among patients with HIV infection in our study [diabetes (1.95%) and prediabetes (7.24%)] was not increased as compared to the occurrence rates in the general population in India 32 33 . In large cross-sectional studies, the prevalence rates of diabetes among HIV-infected patients from Cameroon, Guinea-Bissau and Italy were reported to be 3.8 per cent (n=500), 5.8 per cent (n=953) and 4.5 per cent (n=755), respectively 34 35 36 . There are conflicting reports with a few, but not all studies reporting increased prevalence of diabetes in HIV infected patients 34 35 36 37 .…”

“…In large cross-sectional studies, the prevalence rates of diabetes among HIV-infected patients from Cameroon, Guinea-Bissau and Italy were reported to be 3.8 per cent (n=500), 5.8 per cent (n=953) and 4.5 per cent (n=755), respectively 34 35 36 . There are conflicting reports with a few, but not all studies reporting increased prevalence of diabetes in HIV infected patients 34 35 36 37 . A study from Spain documented lower insulin resistance and lower incidence of diabetes in HIV-infected patients on ART 37 .…”

Diabetes, metabolic syndrome and dyslipidemia in people living with HIV in Africa: re-emerging challenges not to be forgotten

“… 16 , 17 The prevalence of disorders of glucose metabolic process in HIV patients was estimated to range from 2.1% to 26.5% for diabetes and 20.2% to 43.5% for glucose intolerance in some African countries. 18 – 22 The prevalence of type 2 DM was found to be 2.1 % (95 % CI 1.3%–3.2 %) amongst patients living with HIV/AIDS in a public sector facility in Zimbabwe. 22 The estimated prevalence of diabetes was higher in HIV-negative participants in data from surveyed people aged 50 years and over living with and without HIV in Uganda (471 studied, half of them were HIV positive).…”

“… 15 Nevertheless, the prevalence was 5.8% for DM and 5.6% for impaired fasting glucose (IFG) among ART-naïve patients having HIV/AIDS in the main ART center in Guinea-Bissau. 18 …”

“…In the perspective of the expanded danger of dysglycemia in PLWHIV, screening for diabetes and other disorders of glucose metabolism ought to be founded in cART programs in Sub-Saharan Africa. 17 , 18 , 34 Increasing knowledge of health-related risk factors is of paramount importance. Further, it justifies equal research attention and financial commitment in the quest for well-being equity.…”