Diabetes and HIV/AIDS

Table of Contents

• What Is Diabetes?
• Symptoms of Diabetes
• Glucose Tests
• Who Is at Risk for Diabetes?
• What Problems Can Diabetes Cause?
• How Are Diabetes and Pre-Diabetes Treated?
• HIV and Diabetes
• Taking Care of Yourself

What Is Diabetes?

Diabetes and pre-diabetes are serious conditions in which people have high levels of sugar or glucose in their blood. According to the Centers for Disease Control and Prevention (CDC), almost 26 million Americans have diabetes and at least 79 million adults over 20 have pre-diabetes.

Glucose is a type of sugar. It is used as fuel by the body. When you eat, your body converts the food into glucose. The glucose then goes into your bloodstream and is carried throughout the body to provide energy to all of your cells. In order for glucose to move from your bloodstream into your cells, you need insulin. Insulin is a hormone made by the pancreas.

If your body has a problem making or using insulin, the glucose in your bloodstream cannot get into your cells. As a result, glucose stays in the blood (high blood sugar) and the cells do not get enough. A diagnosis of pre-diabetes or diabetes is made when glucose stays at higher than normal levels (also called hyperglycemia).

There are several types of diabetes:

Type 1 Diabetes

• The pancreas does not make any insulin
• You must take insulin every day to survive
• Usually begins in childhood or adolescence

Type 2 Diabetes

• Your pancreas makes some insulin (but usually not enough), and/or the body does not respond normally to the insulin your body does make
• Some people with type 2 diabetes are able to control it with diet and exercise, many others need diabetes medication, and some need insulin
• Most common form of diabetes

Gestational Diabetes

• Diabetes that starts during pregnancy due to hormones that prevent insulin from doing its job
• Most women with gestational diabetes are able to control their diabetes and prevent harm to themselves and their babies; women with gestational diabetes tend to have large babies
• Most often, blood sugar levels return to normal after delivery

Pre-Diabetes

• Blood glucose levels are higher than normal but not high enough for a diagnosis of diabetes
• Having pre-diabetes puts you at increased risk for developing type 2 diabetes
• Type 2 diabetes can often be prevented or delayed by making changes to your diet and increasing exercise

Symptoms of Diabetes

Symptoms of diabetes include:

• Extreme thirst
• Need to urinate frequently
• Unexplained weight loss
• Hunger
• Blurry vision
• Irritability
• Tingling or numbness in the hands or feet
• Difficulty healing
• Extreme fatigue

Symptoms typically occur when glucose levels have gotten very high. If you are diagnosed while diabetes is in its early stages, you may not have any symptoms.

Glucose Tests

Since there are not always obvious symptoms of diabetes, it is important to have regular lab tests to check if your glucose levels are high. The most common glucose tests are:

• Fasting glucose test: measures the glucose in a blood sample taken when you have not had anything to eat or drink (except water) for at least eight hours
• Random glucose test: measures the glucose in a blood sample taken when you have been eating on your usual schedule
• Glucose tolerance test: you take a fasting glucose test and are then given a drink with a measured amount of glucose in it. Several more glucose measurements are taken at specific time intervals after you have had the drink
• Hemoglobin A_1C test: measures your average blood sugar or blood glucose over the last two to three months. This test does not require fasting. It is used to monitor diabetes control as well as to help diagnose it.

To find out if you have diabetes or pre-diabetes, it is generally recommended that you have a fasting glucose test. A glucose tolerance test may be ordered to help diagnose diabetes and as a follow-up to a high fasting glucose level.

A diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:

• A fasting blood glucose level of 126 milligrams per deciliter (mg/dL) or higher
• A random blood glucose level of 200 mg/dL or higher, along with symptoms of diabetes
• A glucose tolerance test level of 200 mg/dL or higher
• An A_1C over 6.5%

Who Is at Risk for Diabetes?

Anyone can get diabetes. However, certain factors may increase your risk, such as:

• Taking certain protease inhibitors (PIs)
• Being over 40
• Being overweight or obese
• A family history of the disease
• A poor diet
• Not exercising regularly
• A lot of fat around the belly (sometimes called "central obesity;" having an apple-shaped body)
• Hepatitis C or liver damage
• High cholesterol
• High blood pressure