Prevalence of insulin resistance and risk of diabetes mellitus in HIV-infected patients receiving current antiretroviral drugs

Araújo, Susana; Bañón, Sara; Machuca, Isabel; Moreno, Ana; Pérez-Elías, María Jesús; Casado, José L.

doi:10.1530/eje-14-0337

Cited by 50 publications

(56 citation statements)

References 59 publications

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“…The prevalence of diabetes is higher in both pre-ART (13.2%) and ART (5.1%) cases, which is similar to a finding from Spain. 14 The prevalence of DM in the ART group is slightly lower than in a report from Jimma in the southwestern part of the country (8.5%), while the prevalence among pre-ART groups is higher than in the report from the southwest (0.9%). 5 The observed high prevalence of DM in the pre-ART group is confounded by a family history of DM; in this study, the number with a family history of DM in the pre-ART group was 13 (8.18%), while it was 11 (4.01%) in the ART group.…”

Section: Key Resultscontrasting

confidence: 57%

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

et al. 2016

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ObjectiveTo assess the prevalence of diabetes mellitus (DM) and associated factors among HIV-infected adults in northwest Ethiopia.DesignHospital-based cross-sectional study.SettingHIV clinic of the University of Gondar Hospital, Ethiopia.ParticipantsAll HIV-infected adults who visited the HIV clinic from December 2013 to the end of February 2014 were the source population.MeasuresA structured and pretested questionnaire incorporating the WHO STEPwise approach was used. A multivariate logistic regression analysis was applied to assess factors associated with DM.ResultsThe overall prevalence of type 2 DM was 8% (95% CI 5.5% to 10.5%). The prevalence of DM was higher (13.2%; 95% CI 8.0% to 18.3%) among subjects receiving pre-antiretroviral treatment (pre-ART) than among those taking ART (5.1%; 95% CI 2.6% to 7.6%). Thirteen (35.1%) of the DM cases were newly identified during the study. Obesity (adjusted OR (AOR) 6.55; 1.20 to 35.8), hypertension (AOR 3.45; 1.50 to 7.90), being in the pre-ART group (AOR 4.47; 1.80 to 11.08), hypertriglyceridaemia (AOR 2.24; 1.02 to 49.5) and tertiary-level education (AOR 11.8; 2.28 to 61.4) were associated with DM.ConclusionsOverall DM prevalence was high, particularly among subjects in the pre-ART group. More educated, hypertensive and obese HIV-infected adults were more likely to have DM as a comorbidity. Health policy and the clinical management of HIV-infected individuals should take into account the rising DM.

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Section: Key Resultscontrasting

confidence: 57%

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

et al. 2016

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“…After a follow-up of 5.2 years, the DAD study revealed a crude incidence of new diabetes of 4.2 cases per 1000 person-years, which is similar to that described in the Swiss cohort (4.6 cases per 1000 person-years) [16,17]. In Spain, Araujo et al [18] reported that the rate of incident diabetes was 2.85 cases per 100 person-years in HIV-infected patients.…”

Section: Introductionsupporting

confidence: 60%

Fifteen-Year Trends in the Prevalence of Diabetes among Hospitalized HIV-Infected Patients in Spain (1997-2012)

et al. 2016

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ObjectiveTo describe trends in the prevalence of diabetes among hospitalized HIV-infected patients between 1997 and 2012 in Spain and compare them with those of age- and sex-matched non–HIV-infected patients.MethodsThe study was based on Spanish national hospital discharge data. We performed a retrospective study for the period 1997–2012. HIV infection (HIV-infected versus non–HIV-infected [control group])and calendar period in relation to widespread use of combination antiretroviral therapy (cART) (1997–1999; 2000–2003; 2004–2007 and 2008–2012), were the exposure variables The outcome variables were diagnosis of diabetes and in-hospital mortality (IHM).ResultsFrom 1997 to 2012, we identified 91,752 cases of diabetes: 15,398 in the HIV-infected group (403,277 hospital admissions) and 76,354 in the non–HIV-infected group (1,503,467 hospital admissions). Overall, HIV-infected patients had lower prevalence values for diabetes than non–HIV-infected patients throughout the follow-up (3.8% vs. 5.1%; p<0.001). The prevalence of diabetes increased 1.56-fold among non–HIV-infected patients and 4.2-fold among HIV-infected patients. The prevalence of diabetes in females was almost twice as high in HIV-infected patients as in non–HIV-infected patients during the last study period (4.72% vs. 2.88%; p<0.001). Diabetes showed a protective effect against IHM throughout the study period (aOR = 0.70; 95%CI, 0.65–0.75).ConclusionsDuring the cART era, the prevalence of diabetes has increased sharply among HIV-infected hospitalized patients compared with matched non–HIV-infected subjects. The prevalence of diabetes is rising very fast among HIV-infected women. Diabetes has a protective effect on IHM among HIV-infected patients. Nevertheless, our study has several limitations. No information is available in the database used on important sociodemographic characteristics and relevant clinical variables including duration of the HIV infection, treatments used, drug resistance, treatment adherence or CD4 count, among others. Also, it is possible that increase of diabetes prevalence could reflect the improvement in recording habits.

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“…A longitudinal study of insulin resistance (IR) in PLWH on newer ART regimens identified IR in 21% of participants, which represents a significant decrease from estimates of 35–63% prevalence IR with older ART regimens. [5–7] However, the decrease in IR occurred alongside an increase in diabetes diagnoses and obesity prevalence. Diabetes prevalence estimates in PLWH range as high as 14%, but (1) vary significantly depending on the population studied, (2) often do not distinguish between type 1 and type 2 diabetes, and (3) do not include estimates of PLWH with undiagnosed diabetes.…”

Section: Metabolic Complications Are Increasing Among People Living Wmentioning

confidence: 99%

Metabolic Complications and Glucose Metabolism in HIV Infection: A Review of the Evidence

2016

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HIV infection and antiretroviral therapy (ART) use are associated with perturbations in glucose and lipid metabolism. Increasing incidence of diabetes, cardiovascular disease, and obesity highlights the need for early identification and treatment of metabolic dysfunction. Newer ART regimens are less toxic for cellular function and metabolism but have failed to completely eliminate metabolic dysfunction with HIV infection. Additional factors, including viral-host interactions, diet, physical activity, non-ART medications, and aging may further contribute to metabolic disease risk in the HIV setting. We summarize the recent literature regarding the impact on metabolic function of HIV infection, ART, and pharmaceutical or lifestyle prescriptions.

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Prevalence of insulin resistance and risk of diabetes mellitus in HIV-infected patients receiving current antiretroviral drugs

Cited by 50 publications

References 59 publications

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

Diabetes mellitus among HIV-infected individuals in follow-up care at University of Gondar Hospital, Northwest Ethiopia

Fifteen-Year Trends in the Prevalence of Diabetes among Hospitalized HIV-Infected Patients in Spain (1997-2012)

Metabolic Complications and Glucose Metabolism in HIV Infection: A Review of the Evidence

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