Side Effects of HIV Medicines. Diabetes is a disease in which levels of glucose in the blood (also called blood sugar) are too high. People with HIV should have their blood glucose levels checked before they start taking HIV medicines. This paper reviews the incidence, pathogenetic mechanisms and management strategies of diabetes mellitus in patients with human. Standards of treatment and management of diabetes for patients with HIV generally are the same as those for diabetic patients.
in Diabetes Management Aids
Insulin resistance among treated HIV-infected patients is multifactorial. It includes common contributors to insulin resistance such as obesity, genetic influences, and physical inactivity; antiretroviral drugs and lipodystrophy [ 53 ].
The coexistence of obesity, glucose intolerance, dyslipidemia, and hypertension, is termed as insulin resistance syndrome [ 54 ]. Insulin resistance is manifested early in the natural history of the disease but glucose tolerance remains normal because of a compensatory increase in insulin secretion and hyperinsulinemia [ 55 ]. Impaired glucose tolerance IGT is a pre-diabetic state of dysglycemia that is associated with insulin resistance and increased risk of cardiovascular pathology [ 56 ].
Protease inhibitors do not increase risk of glucose intolerance or insulin resistance among pregnant women [ 58 ]. Diabetes is a chronic disorder characterized by high levels of glucose in the blood and is a common disorder affecting individuals of all ages [ 59 ]. Hyperglycemia is a symptom of Diabetes [ 60 ]. Hyperglycemia, new-onset diabetes mellitus, exacerbation of existing diabetes mellitus, and diabetic ketoacidosis has been reported in HIV-infected patients taking PIs.
Diabetes mellitus, one of the most prevalent diseases in developing world, is a metabolic disorder characterized by hyperglycemia and other metabolic alterations due to relative or absolute insulin deficiency [ 61 ]. The risk of developing hyperglycemia is the same with all PIs. People who are older, obese [ 62 ], family history with diabetes are also at greater risk for developing hyperglycemia [ 60 ]. Hyperglycemia is also associated with excessive free radical generation and oxidant stress [ 63 ].
Current therapies require lifelong treatment which can be associated with significant toxicity and economic cost. In some instances, the use of cART may be restricted by contraindications, drug resistance, or limited access. There is a need for simple treatment options which provide sustained potency, limited toxicity, and a high genetic barrier to development of resistance [ 64 ].
Understanding the glucose disturbances that are possible with PI therapy, performing appropriate screening for glucose intolerance and diabetes and making prudent changes in HIV therapy when necessary, and treating patients for alterations in glucose metabolism are the key components of care for at-risk patients [ 14 ]. Maintaining a healthy weight and increasing physical activity, Diabetes treatment, with oral agents or insulin may be useful [ 44 ]. Counseling will be an important requirement for Anti Retroviral treatment [ 3 ].
Research suggests that physical activity is inversely related to numerous metabolic disorders in people who are living with HIV [ 66 ]. Despite all the advances in diabetes treatment, education remains the cornerstone of diabetes management.
Diabetes education is important in improving diabetes self-management and providing effective diabetes treatment. Differences in diet, exercise levels, stress and other factors may all affect blood glucose levels, so people should be educated about how these factors affect them and the various control measures [ 67 ]. Psychosocial support is an integral part of effective diabetes management; it is of utmost importance in patients who have to handle the double stress of diabetes and HIV. Insulin is the drug of choice for management of diabetes with HIV.
HIV-infected patients should be taught how to dispose of lancets, glucose strips, insulin syringes, pens and needles, to prevent HIV transmission [ 65 ]. PI-based regimes should be avoided in patients at high risk of developing diabetes.
Patients should be counselled about the potential risks, discomforts and benefits of HAART, and encouraged to follow a healthy lifestyle while monitoring glycemia regularly. The effective management of diabetes in HIV infected patients requires a thorough understanding of pathophysiology and pharmacology [ 65 ].
The recent development of highly active antiretroviral therapy HAART has drastically improved the life expectancy of AIDS patients but the long-term use of novel, potent antiviral agents has lead to new problems and complications.
Hence there is a need for simple treatment options which provide sustained potency, limited toxicity, and a high genetic barrier to development of resistance. The effective management of diabetes in HIV infected patients is therefore required to avoid undesirable consequences. I would like to express my fullest gratitude to all my friends who helped me in successful completion of this review article.
Home Publications Conferences Register Contact. Guidelines Upcoming Special Issues. Review Article Open Access. Hima Bindu A P. In both the cases, the risk of developing active TB increases several fold.
According to Chaisson et al. The drug resistant forms worsen the management of active TB cases, and are responsible for very high mortality rate among PLHA and may undermine the current TB control strategies especially in low and middle-income countries [ 37 , 38 ]. HIV-TB co-infection complicates both the diagnosis and treatment of tuberculosis. Because the sputum smear microscopy in HIV infected persons were, reportedly having reduced sensitivity than that of HIV uninfected persons. The most common treatment challenges include, pill burden and overlapping toxic effects of ATT and ART, drug interactions, patient compliance and immune reconstitution inflammatory syndrome.
It has long been recognized that infective agents may predispose to, or trigger, some chronic noncommunicable diseases [ 11 ]. Now, it has become evident that two of the most common infectious diseases, TB and HIV, may also be closely related to chronic noncommunicable disease [ 3 ]. Based on the available evidence, it is clearly understood that, diabetes predisposes to TB [ 2 , 13 ], whereas with limited evidence TB may also predispose to diabetes [ 40 ]. Hence, we call for the action of considering all the three diseases together for diagnosis and management to improve the case detection, early treatment and possible prevention.
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I first found out I was HIV positive in This happened after the man I love became extremely sick. At first when I found out, I reacted just like anyone else.
I thought my life was over. My mother was saddened by the news. I was scared to tell anyone. Some studies have also shown that people with HIV may be at higher risk of developing diabetes.
For this reason it is important to remain conscious of your future blood sugar levels even if your next test shows they have returned to normal.
The positive news is that because there are relatively high numbers of people living with both HIV and diabetes there is a good level understanding around treatment.
You asked what type of treatments you would be likely to be put on. Many people are able to control diabetes through lifestyle changes such as increased exercise and weight loss. Healthy eating and stopping smoking are also important for diabetes treatment. HIV positive people with diabetes should see a specialist HIV dietitian for help with dietary changes. HIV dietitians can help balance any dietary requirements to do with ARV treatment with the needs of diabetic treatment.
Some ARVs are also implicated in causing increased glucose levels. Your doctor should review which ARVs you are receiving to see if these could be affecting your diabetes. Could you tell me which ARVs you are currently receiving?
Finally if diabetes cannot be controlled through changes in lifestyle changes or ARV changes treatment with diabetic drug therapy is recommended. For more information on the drug therapies used in treating diabetes alongside HIV please follow this link. Has your Mom talked to the doctor about her treatment?
Because as Rebecca say above, the positive news is that because there are relatively high numbers of people living with both HIV and diabetes there is a good level understanding around treatment.
Also, many people are able to control diabetes through lifestyle changes such as increased exercise and weight loss.
So it would be great if your Mom could discuss treatment with the doctor and with a dietitian. How is your Mom? Hi all my mom have been living with hiv for some years and she recently found out shes diabetic, what are her chances of living a normal healthy life?
Is her life in danger.
Tuberculosis, HIV/AIDS and Diabetes - Is it Time to Think Together?
Diabetes Manage. SUMMARY Patients with HIV can now expect an improved life expectancy following the introduction of combined antiretroviral therapy. This review covers the epidemiology of diabetes mellitus (DM) in HIV-infected patients, and diagnosis, management, and treatment goals for. Antiretroviral therapy (ART) may be the single most consistent determinant of diabetes in patients with HIV, according to a study in Diabetes.