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Poor Blood Sugar Control and Overall Care in People With Diabetes and HIV

March 2011

One third of people with HIV and diabetes in a New York City university medical center had poor control of blood sugar, and low proportions met guidelines for blood pressure, cholesterol, and triglycerides.1 In addition, physicians tested few of these people with HIV and diabetes for serious diabetes complications.

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One in 10 US adults has diabetes, a disease marked by high sugar levels in the blood. Diabetes rates are especially high in African Americans and Hispanics.2 Diabetes is a serious lifelong disease that can cause high blood pressure, heart disease, kidney disease, and blindness. HIV and two types of antiretrovirals -- nucleosides and protease inhibitors -- may contribute to the risk of diabetes. In a study of US gay men, the diabetes rate was 4 times higher in those with HIV than in those without HIV.3

Earlier studies found poor blood sugar control in people with diabetes and HIV.4,5 Researchers at a New York City university medical center planned this study to see how well blood sugar is controlled in their patients with diabetes and HIV, and to identify factors that may contribute to poor blood sugar control. The study also aimed to determine whether people with diabetes and HIV met American Diabetes Association guidelines6 for blood pressure and lipids (blood fats) and whether they were tested for eye and kidney complications of diabetes.

American Diabetes Association Goals for People With Diabetes6

  • Blood pressure: below 130/80 mm Hg
  • "Good" high-density lipoprotein (HDL) cholesterol: above 40 mg/dL in men and above 50 mg/dL in women
  • "Bad" low-density lipoprotein (LDL) cholesterol: below 100 mg/dL
  • Triglycerides: below 150 mg/dL


References

  1. Satlin MJ, Hoover DR, Glesby MJ. Glycemic control in HIV-infected patients with diabetes mellitus and rates of meeting American Diabetes Association management guidelines. AIDS Patient Care STDs. 2011;25:5-12.
  2. Centers for Disease Control and Prevention. National Diabetes Fact Sheet, 2007. www.cdc.gov/diabetes/pubs/factsheet11.htm. Accessed February 5, 2011.
  3. Brown TT, Cole SR, Li X, et al. Antiretroviral therapy and the prevalence and incidence of diabetes mellitus in the Multicenter AIDS Cohort Study. Arch Intern Med. 2005;165:1179-1184.
  4. Adeyemi O, Vibhakar S, Max B. Are we meeting the American Diabetes Association goals for HIV-infected patients with diabetes mellitus? Clin Infect Dis. 2009;49:799-802.
  5. Bury JE, Stroup JS, Stephens JR, Baker DL. Achieving American Diabetes Association goals in HIV-seropositive patients with diabetes mellitus. Proc (Bayl Univ Med Cent). 2007;20:118-123.
  6. American Diabetes Association. Standards of medical care in diabetes -- 2011. http://care.diabetesjournals.org/content/34/Supplement_1/S11.full. Accessed February 5, 2011.




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