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Original article

Incident hyperglycaemia among older adults with or at-risk for HIV infection

Sarit Polsky, Michelle Floris-Moore, Ellie E Schoenbaum, Robert S Klein, Julia H Arnsten, Andrea A Howard

Corresponding author name: Andrea A Howard
Corresponding author e-mail: aah2138@columbia.edu

Citation: Antiviral Therapy 2011; 16:181-188
doi: 10.3851/IMP1711

Date accepted: 15 July 2010
Date published online: 12 January 2011

Abstract

Background: HIV infection has been associated with development of prediabetes and diabetes. Optimum screening practices for these disorders in HIV-infected populations remain unclear.

Methods: We screened 377 adults, with or at-risk for HIV infection, for incident hyperglycaemia (prediabetes or diabetes) using two oral glucose tolerance tests (OGTTs) a median of 18.6 months apart. We determined proportion of incident cases detected by fasting and 120-min plasma glucose levels. Independent predictors of incident hyperglycaemia were identified using logistic regression.

Results: The baseline OGTT was consistent with diabetes in 7% of participants and with prediabetes in 31%. Among 352 normoglycaemic and prediabetic participants at baseline, 19 (5%) developed diabetes on follow-up. Among participants normoglycaemic at baseline, an additional 38 (16%) developed prediabetes. Overall 52% of incident hyperglycaemia cases were detected by fasting plasma glucose alone, 33% by a 120-min glucose level alone and 15% by both. Factors independently associated with incident hyperglycaemia included age ≥50 years and body mass index ≥30 kg/m2. Neither HIV infection nor highly active antiretroviral therapy (HAART) use were associated with increased risk of diabetes.

Conclusions: Incident hyperglycaemia is common among older adults with or at-risk for HIV infection. HIV-infected individuals with classic diabetes risk factors should be screened for hyperglycaemia regardless of HAART use. OGTTs might be the preferred screening strategy in HIV-infected individuals at high risk for developing hyperglycaemia.

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