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Increased risk of prediabetes among virally suppressed adults with HIV in Central Kenya detected using glycated haemoglobin and fasting blood glucose
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Increased risk of prediabetes among virally suppressed adults with HIV in Central Kenya detected using glycated haemoglobin and fasting blood glucose
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Journal Article
Increased risk of prediabetes among virally suppressed adults with HIV in Central Kenya detected using glycated haemoglobin and fasting blood glucose
2021
Overview
Aims As survival among people living with HIV (PLHIV) improves with universal HIV treatment, new strategies are needed to support management of co‐morbidities like type 2 diabetes (T2D). We assessed prediabetes and T2D prevalence and risk factors using haemoglobin A1c (HbA1c) among PLHIV on antiretroviral therapy (ART) in Central Kenya. Methods This cross‐sectional study, conducted at a rural and urban site, enrolled PLHIV aged ≥35 years on ART for at least 5 years. HbA1c was assayed using Cobas b 101®, a point‐of‐care device. HbA1c levels ≥6.5% were considered diagnostic of T2D. For pre‐diabetic HbA1c levels (5.7%–6.4%), participants were requested to return the following day for a fasting blood glucose (FBG) to rule out T2D. Risk factors were assessed using multivariable log‐binomial regression. Results Of the 600 completing study procedures, the prevalence of diabetes was 5% (30/600). Ten participants were known to have diabetes; thus, prevalence of newly diagnosed T2D was 3.4% (20/590). Prevalence of prediabetes (HbA1c 5.7%–6.4%) was 14.2% (84/590). Significant predictors of elevated HbA1c were increase in age (Prevalence ratio [PR]: 1.10, CI: 1.02, 1.18, p = .012), hypertension (PR: 1.43, CI: 1.07–2.3, p = .015), central adiposity (PR: 2.11, CI: 1.57–2.84, p < .001) and use of Efavirenz (PR: 2.09, CI: 1.48, 2.96, p < .001). Conclusion There is a high prevalence of prediabetes, a significant predictor of T2D, among PLHIV in Central Kenya. Point‐of‐care HbA1c may help identify PLHIV with prediabetes in a single screening visit and provide an opportunity for early intervention. The article highlights the need for T2D screening especially among African people with HIV who are aviremic using standard diagnostic measures. The results show a high prevalence of prediabetes (14%) with a significant proportion of them expected to develop overt diabetes and ultimately its costly complications.
Publisher
John Wiley & Sons, Inc,John Wiley and Sons Inc,Wiley
Subject
/ Anemia
/ Diabetes
/ Diabetes Mellitus, Type 2 - complications
/ Diabetes Mellitus, Type 2 - drug therapy
/ Diabetes Mellitus, Type 2 - epidemiology
/ Fasting
/ Females
/ Glucose
/ HIV
/ HIV Infections - complications
/ HIV Infections - drug therapy
/ HIV Infections - epidemiology
/ Human immunodeficiency virus
/ Humans
/ Original
/ Prediabetic State - diagnosis
