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Under-utilisation of cardioprotective glucose-lowering medication in diabetics living with HIV

Bakani Butale1, Ian Woolley2, Kathryn Cisera3

  • 1Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia.

Sexual Health
|August 22, 2022
PubMed

Insights

Diabetes is common in people with HIV (PLWH). Uptake of beneficial SGLT2i and GLP1RA medications for diabetic PLWH remains low, necessitating careful prescribing.

Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Cardiology

Background:

  • Diabetes mellitus is a frequent comorbidity in people living with HIV (PLWH).
  • Sodium glucose transporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP1RA) have demonstrated cardiovascular benefits in diabetic populations.
  • Understanding the utilization of these beneficial agents in PLWH is crucial for optimizing care.

Approach:

  • A retrospective cohort study was conducted involving 262 PLWH at Monash Health over a 1-year period.
  • Medical charts were reviewed to determine the prevalence of diabetes and the rates of SGLT2i and GLP1RA use.
  • Data analysis focused on identifying prescribing patterns for glucose-lowering medications in this population.

Key Points:

  • The prevalence of diabetes among the studied PLWH was 13.4%.
  • A significant proportion (60%) of diabetic PLWH experienced microvascular and/or macrovascular complications.
  • Only 4% of diabetic PLWH were prescribed SGLT2i, and 19% were prescribed GLP1RA.

Conclusions:

  • Current use of SGLT2i and GLP1RA in diabetic PLWH is suboptimal, despite their established benefits.
  • Prescribers should consider the cardiovascular advantages of SGLT2i and GLP1RA when managing diabetes in PLWH.
  • Further research and clinical guidelines may be needed to improve the uptake of these effective therapies in this vulnerable population.

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