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25 Things You Need to Do if You Have HIV

June 2011

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25. Get your blood sugar tested after fasting at least once a year to see if you have pre-diabetes or diabetes.

  • Average score: 3.58 (with 5 the highest and 1 the lowest)
  • Percentage voting 5: 26%
  • Percentage voting 4 or 5: 65%
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People with HIV run a high risk of pre-diabetes (high blood glucose levels) and diabetes.1-3 Diabetes can raise the risk of coronary artery disease, stroke, and kidney disease.4

HIV care experts recommend measuring blood glucose (blood sugar) after fasting every 6 to 12 months -- and 3 to 6 months after starting new HIV medications -- to check for high glucose levels or diabetes.4,5

High blood glucose can be prevented or controlled by watching your weight, planning a healthy diet, and exercise. For specific information on preventing diabetes, see the link at the American Diabetes Association site below.6 Excessive hunger or thirst and increased urination can be signs of blood sugar problems.4

References

  1. Samaras K. Prevalence and pathogenesis of diabetes mellitus in HIV-1 infection treated with combined antiretroviral therapy. J Acquir Immune Defic Syndr. 2009;50:499-505.
  2. Brown TT, Li X, Cole SR, et al. Cumulative exposure to nucleoside analogue reverse transcriptase inhibitors is associated with insulin resistance markers in the Multicenter AIDS Cohort Study. AIDS. 2005;19:1375-1383.
  3. Hitti J, Andersen J, McComsey G, et al. Protease inhibitor-based antiretroviral therapy and glucose tolerance in pregnancy: AIDS Clinical Trials Group A5084. Am J Obstet Gynecol. 2007;196:331.e1-e7.
  4. US Department of Health and Human Services Health Resources and Services Administration. Guide for HIV/AIDS clinical care. January 2011. Pages 333-337. http://hab.hrsa.gov/deliverhivaidscare/clinicalguide11/pdf/p07-cg/CM_Jan2011.pdf. Accessed June 20, 2011.
  5. Aberg JA, Kaplan JE, Libman H, et al; HIV Medicine Association of the Infectious Diseases Society of America. Primary care guidelines for the management of persons infected with human immunodeficiency virus: 2009 update by the HIV Medicine Association of the Infectious Diseases Society of America. Clin Infect Dis. 2009;49:651–681. http://cid.oxfordjournals.org/content/49/5/651.full. Accessed May 19, 2011.
  6. American Diabetes Association. How to prevent prediabetes. www.diabetes.org/diabetesbasics/prevention/pre-diabetes/how-to-prevent-pre-diabetes.html. Accessed June 23, 2011.


Other Tips From Our Expert Panel

  • Work to develop a strong, trusting relationship with your provider and have a discussion about the suitability of HIV therapy very early on. (Peter Hunt)
  • Become be an active participant in your health: ask your provider questions and complete all the forms needed for your care and insurance. (Carl Fichtenbaum)
  • Don't be afraid to ask your provider about the likely course of your HIV infection. For most people the expected course if often very good, and this knowledge can be reassuring. (Amalio Telenti)
  • Be aware that most people live productive lives while taking HIV drugs. The earlier people start treatment, the better they do. HIV treatments are much easier to take now than they used to be, with fewer pills and fewer side effects. (Peter Hunt)
  • Tell current and former sex partners and needle-sharing partners that you have HIV. (Andrew Carr)
  • Tell your provider who else knows about your HIV in your family or among friends. If you have not told anyone you have HIV, discuss this with your provider. (Judith Currier)
  • Especially when you're starting a new HIV drug, make sure you know the possible side effects so you can tell your provider if those problems develop. (Amalio Telenti)
  • Discuss potential long-term complications of your HIV treatment with your provider and how these might be prevented. (Andrew Carr)
  • Ask your provider whether you can participate in or contribute to HIV research projects. It will make you feel like an engaged member of the HIV community and help advance knowledge for all. (Amalio Telenti)


Survey Respondents

Todd T. Brown, M.D., Ph.D., Johns Hopkins University, Baltimore, Maryland
Andrew Carr, MBBS, M.D., University of New South Wales, Sydney, Australia
David A. Cooper, MBBS, M.D., D.Sc., University of New South Wales, Sydney, Australia
Judith S. Currier, M.D., M.Sc., University of California, Los Angeles
Eric S. Daar, M.D., David Geffen School of Medicine at UCLA, Los Angeles, California
Steven G. Deeks, M.D., University of California, San Francisco
Carl J. Fichtenbaum, M.D., University of Cincinnati, Cincinnati, Ohio
Charles W. Flexner, M.D., Johns Hopkins University, Baltimore, Maryland
Joel E. Gallant, M.D., M.P.H., Johns Hopkins University, Baltimore, Maryland
Marshall J. Glesby, M.D., Ph.D., Weill Cornell Medical College, New York, NY
Steven K. Grinspoon, M.D., Harvard Medical School, Boston, Massachusetts
Keith Henry, M.D., University of Minnesota, Minneapolis, Minnesota
Charles B. Hicks, M.D., Duke University Medical Center, Durham, North Carolina
Bernard Hirschel, M.D., Ph.D., Geneva University Hospital, Geneva, Switzerland
Peter W. Hunt, M.D., University of California, San Francisco
Donald P. Kotler, M.D., Columbia University College of Physicians and Surgeons, New York, NY
David M. Margolis, M.D., University of North Carolina, Chapel Hill, North Carolina
Stefan Mauss, M.D., Ph.D., Center for HIV and Hepatogastroenterology, Düsseldorf, Germany
Peter Reiss, M.D., Ph.D., Academic Medical Center, Amsterdam, Netherlands
Gregory K. Robbins, M.D., Massachusetts General Hospital, Boston, Massachusetts
Jürgen Rockstroh, M.D., Ph.D., University of Bonn, Bonn, Germany
Jonathan Schapiro, M.D., Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
David M. Smith, M.D., University of California, San Diego
Pablo Tebas, M.D., University of Pennsylvania, Philadelphia, Pennsylvania
Amalio Telenti, M.D., Ph.D., Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
Annemarie Wensing, M.D., Ph.D., University Medical Center Utrecht, Utrecht, Netherlands
Andrew Zolopa, M.D., Stanford University, Stanford, California

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This article was provided by The Center for AIDS. Visit CFA's website to find out more about their activities and publications.
 
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