On this World AIDS Day, we would like to extend our support by creating awareness about the risk of diabetes in people living with HIV. After all, awareness might help us be well-equipped to prevent and manage this disease.
Background: HIV/AIDS
Human immunodeficiency virus (HIV), first identified in 1981, continues to be a significant public health issue.1,2 Once the virus enters the body, it destroys the immune system by destroying the cells responsible for fighting infections. In the absence of our body’s natural defence system, our body becomes more prone to infections and diseases.1
When left untreated, HIV results in acquired immunodeficiency syndrome (AIDS), a late stage of HIV infection. A person is said to have AIDS when their body’s defence system is severely impaired due to the virus. Individuals with AIDS may survive for about three years without HIV medicines.1
Statistics
As of 2018, approximately 37.9 million people globally are living with HIV:3 no wonder HIV has become one of humanity’s deadliest epidemics.1 However, a global commitment to increase access to effective HIV treatment and prevention has gone a long way in reducing the prevalence of the disease. The number of deaths due to AIDS-related illnesses has come down from 1.7 million in 2004 to 770,000 in 2018.3
Complications
Unfortunately, our body is incapable of naturally weeding out HIV. Additionally, no cure has been discovered yet.1 However, advances in HIV diagnosis and treatment with antiretroviral therapy (ART) have decreased the number of deaths due to HIV-related complications, thereby allowing people with HIV and AIDS to live longer.4
Consequently, there has also been a rise in age-related illnesses in such individuals.4 Most diseases seen in individuals living with HIV are age-related illnesses, as seen in the general population. Additionally, HIV and some antiretroviral medicines are also responsible for the early development of chronic conditions like type 2 diabetes.5
What is diabetes?
Our pancreas produces a substance called insulin so that the cells in our body can use the glucose we ingest. Diabetes can be of different types, such as type 1, type 2 or gestational diabetes. Type 2 diabetes occurs when the body does not produce enough insulin or the cells are unable to use the insulin produced by the body to process glucose. Type 1 diabetes occurs when the pancreas does not make insulin. Type 2 diabetes is the most common type of diabetes seen in people living with HIV.6,7
Risk factors for diabetes
Individuals with HIV are four times more likely to have type 2 diabetes than those without HIV. In comparison to the general population, the risk of diabetes in individuals with HIV increases based on factors such as:5
- Duration of HIV infection
- The extent to which the body’s immune/defence system has been destroyed
- Exposure to certain HIV medicines
Other factors responsible for the increased risk of type 2 diabetes in people with HIV are:7
- Age, 45 years or older
- Family history of diabetes
- Being overweight or obese
- Lack of physical activity
Symptoms of diabetes
People living with HIV should get themselves tested for diabetes immediately if they have any of the following symptoms:7
- Frequent urination
- Abnormal weight loss
- Blurred vision
- Sores that do not heal
- Increased thirst
- Increased hunger
- Fatigue
- Tingling or numbness in the hands or feet
Screening for diabetes
Individuals with HIV should be screened for diabetes at the following three stages:8
- When HIV is diagnosed
- At the beginning of HIV treatment
- Three to six months after HIV treatment
It is essential to check for diabetes before starting with ART as certain medicines may not be advisable in individuals with high blood glucose levels.7
How to prevent or manage diabetes?
We recommend the following tips for people living with HIV to prevent or manage type 2 diabetes:6,7
- Healthy diet: Limit the intake of foods high in sugar, salt and fats. Make healthy food choices.
- Watch your weight: In case you are obese or overweight, your primary aim should be to shed those extra kilos.
- Move your body: Undertake any physical activity for most days of the week.
- Quit smoking
If you are living with HIV, talk to your healthcare professional to know your risk for diabetes.7
If you are among those who are living with HIV, don’t lose heart. Know that we are working together in the fight against HIV/AIDS.
References:
- HIV.gov. What are HIV and AIDS? [Internet]. [updated 2019 Jun 17; cited 2019 Nov 25]. Available from: https://www.hiv.gov/hiv-basics/overview/about-hiv-and-aids/what-are-hiv-and-aids.
- World Health Organization. HIV/AIDS [Internet]. [updated 2019 Nov 15; cited 2019 Nov 25]. Available from: https://www.who.int/news-room/fact-sheets/detail/hiv-aids.
- HIV.gov. Global statistics [Internet]. [updated 2019 Jul 31; cited 2019 Nov 25]. Available from: https://www.hiv.gov/hiv-basics/overview/data-and-trends/global-statistics.
- Fazekas-Lavu M, Tonks KTT, Samaras K. Benchmarks of diabetes care in men living with treated HIV-infection: A tertiary center experience. Front Endocrinol. 2018 Oct 31;9:634. doi: https://doi.org/10.3389/fendo.2018.00634.
- Duncan AD, Goff LM, Peters BS. Type 2 diabetes prevalence and its risk factors in HIV: A cross-sectional study. PLoS One. 2018 Mar 12;13(3):e0194199. doi: 10.1371/journal.pone.0194199.
- Terrence Higgins Trust. Diabetes [Internet]. [updated 2018 Jan 1; cited 2019 Nov 25]. Available from: https://www.tht.org.uk/hiv-and-sexual-health/living-hiv-long-term/diabetes.
- AIDSinfo. HIV and diabetes [Internet]. [updated 2019 Oct 18; cited 2019 Nov 25]. Available from: https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/22/59/hiv-and-diabetes.
- The Association of Physicians of India. HIV & diabetes – A double trouble [Internet]. [cited 2019 Nov 25]. Available from: http://www.apiindia.org/pdf/medicine_update_2017/mu_028.pdf.
