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HIV and Diabetes
Feb 1, 2012

Dear Nelson,

I was told by my HIV doc that I am pre-diabetic and that may progress to diabetes which he says is more common in HIV Poz patients which is something I never heard before.

I do have several poz friends who developed diabetes a few years after they found they were diabetic so I didnt question my doc but my numbers are great (975 CD4 and undetectable now for three years).

Is diabetes more frequent in HIV? Is it the meds or a change in metabolism? Is it inevitable I will go from pre-diabetes to being a diabetic because of the hiv? While I admit being overweight (my BMI is 32...yes 32 and I have started working with a trainer to get back in shape) most of the weight I gained after becoming poz (I went from 175 at 5' 10" to 210 three years later). What can I do to avoid going from pre-diabetes to being a diabetic if anything?

Cant seem to get many answers even from my endocrinologist so I am throwing you this as a tough question.


Response from Mr. Vergel


Thanks for the great question.

As you know by now, prediabetes is a condition in which blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes. This condition is sometimes called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. The U.S. Department of Health and Human Services estimates that about one in four U.S. adults aged 20 years or olderor 57 million peoplehad prediabetes in 2007.

People with prediabetes are at increased risk of developing type 2 diabetes which is defined as the form of diabetes that develops when the body does not respond properly to insulin, as opposed to type 1 diabetes, in which the pancreas makes little or no insulin.

Studies have shown that most people with prediabetes develop type 2 diabetes within 10 years, unless they lose 5 to 7 percent of their body weightabout 10 to 15 pounds for someone who weighs 200 poundsby making changes in their diet and level of physical activity. People with prediabetes also are at increased risk of developing cardiovascular disease.

I am glad that you have a trainer now and that you are determined to lose weight. I would also follow the following suggestions:

1- Read this article and try to follow a high fiber, slow carb, moderate protein and fat diet: Healthy Eating

2- Exercise following these suggestions:

Best Exercise Tips

3- You did not mention your HIV drug regimen. There are some medications that may be friendlier than others when it comes to insulin resistance

4- Make sure that your testosterone and thyroid hormone blood levels are within normal ranges since deficiencies can make you more prone to weight gain

5- After you lose 5% of your body weight, have your doctor go a glucose tolerance test to see where you are in the glucose response curve. This will tell you if you have normalized your pre diabetes or if you have to lose some more weight. The challenge after that is to keep the weight off and to adopt all the life style changes that you learned through this process!


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