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HIV and type 2 diabetes: An evolving story
Harriet Daultrey1, Tom Levett1, Nick Oliver2
1Brighton and Sussex Medical School, Brighton, UK.
HIV Medicine
|December 19, 2023
Summary
People living with HIV (PLWH) face a higher risk of type 2 diabetes. Current guidelines should not restrict HbA1c screening for diabetes in PLWH, who require annual screening.
Area of Science:
- Endocrinology
- Infectious Diseases
- Public Health
Background:
- Diabetes is more prevalent in people living with HIV (PLWH), with data largely from the early HIV era.
- Clinical guidelines recommend diabetes screening for PLWH on antiretroviral therapy (ART).
- Discrepancies exist in international guidelines regarding the optimal glycaemic marker for diabetes screening in PLWH.
Purpose of the Study:
- To review the association between HIV and type 2 diabetes over time.
- To examine the evidence regarding HbA1c discrepancies in PLWH.
- To provide recommendations for diabetes screening in PLWH.
Main Methods:
- Literature review summarizing studies on HIV and type 2 diabetes.
- Analysis of evidence on HbA1c underestimation in PLWH.
- Synthesis of current international HIV clinical guidelines.
Main Results:
- Evidence suggests HbA1c may underestimate glycaemia in PLWH.
- There is no clear basis to restrict HbA1c screening for diabetes based on HIV status.
- Annual diabetes screening for PLWH is recommended, aligning with national guidelines.
Conclusions:
- International guidelines should not restrict HbA1c screening for diabetes in PLWH.
- Annual diabetes screening for PLWH is advised, consistent with general population guidelines.
- Further research is needed on the phenotype and natural history of type 2 diabetes in diverse PLWH populations.
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