Impaired fasting glucose levels among perinatally HIV-infected adolescents and youths in Dar es Salaam, Tanzania

Abstract

ObjectiveThis study assessed impaired fasting glucose and associated factors among perinatally HIV-infected adolescents and youths in Dar es salaam Tanzania.BackgroundImpaired fasting glucose is a marker of heightened risk for developing type 2 diabetes among perinatally HIV-infected individuals. Therefore, identifying individuals at this stage is crucial to enable early intervention. Therefore, we assessed impaired fasting glucose (IFG) and associated factors among perinatally HIV-infected population in Dar es salaam Tanzania. MethodsA cross-sectional study was conducted among 152 adolescents and youth attending HIV clinic at Muhimbili National Hospital and Infectious Disease Centre from July to August 2020. Fasting blood glucose (>8 hours) was measured using one-touch selects LifeScan, CA, USA. We also examined C-Reactive Protein and interleukin-6 inflammatory biomarkers in relation to impaired fasting glucose (IFG). Associations between categorical variables were explored using Chi-square, and poison regression with robust variance was used to calculate the prevalence ratios.ResultsOf the 152 participants, the majority were male (n=83[54.6%]), and the median age was 15(14-18) years. Overweight or obesity was prevalent in 16.4%, while more than one in ten (13.2%) had high blood pressure (≥149/90mmHg). All participants were on antiretroviral therapy (ART); 46% had used medication for over ten years, and about one in three had poor medication adherence. Among the recruited participants, 29% had impaired fasting glucose. The odds of IFG were two times higher in males compared to females (PR, 2.07, 95% CI 1.19 -3.59 p=0.001). Moreover, we found with every increase of Interleukin 6 biomarker there was a 1.01 probability increase of impaired fasting glucose (PR, 1.01, 95% CI 1.00 – 1.02 p=0.003).ConclusionAbout one in three perinatally HIV-infected youths had impaired fasting glucose in Dar es Salaam, Tanzania, with males bearing the biggest brunt. Moreover, with every increase of 1.101 of the probability of having IFG increased. This calls for urgent measures to interrupt the progression to diabetes disease and prevent the dual burden of disease for this uniquely challenged population.

High prevalence of impaired glucose metabolism among children and adolescents living with HIV in Ghana

“…The prevalence of elevated FBS levels in our study is lower than in a recent study conducted among adolescents in Tanzania (46%). This could be due to the higher levels of overweight or obese individuals in the Tanzania study [7].…”

“…Therefore, children who acquired HIV mainly through mother-to-child transmission are at a higher risk of developing metabolic disorder due to lifelong exposure to ART from childhood. Studies assessing impaired glucose metabolism in children and adolescents living with HIV (CALWH) have reported varying prevalence rates, ranging from as low as 1.6% to as high as 40%, depending on the population studied [7][8][9]. However, although impaired glucose metabolism in children, including insulin resistance, could be a risk or predictor of cardiovascular disease in adulthood [10,11], diagnosing glucose impairment in children is challenging as it often presents asymptomatically [12].…”

“…Therefore, in populations with high HIV infections, the prevalence of impaired glucose metabolism in children could be high [16]. Although only a few studies have monitored glucose tolerance or sensitivity in children living with HIV in sub-Saharan Africa, where 90% of the paediatric HIV population resides, the reported prevalence of impaired glucose is high compared with the paediatric population without HIV [4,7,[17][18][19]. Interestingly, the majority of these individuals with impaired glucose levels are non-obese and primarily exhibit subclinical manifestations [20].…”

“…Recent reports have indicated that the prevalence of impaired glucose metabolism in children living with HIV is on the increase [7,21]. To effectively manage these disorders, it is crucial to identify impaired glucose metabolism in children and adolescents and develop appropriate management strategies.…”