Diabetes is a condition characterised by high blood sugar which, if left untreated, can damage the blood vessels and organs, leading to serious complications. The chronic disease also increases the risk of associated infections, including the human immunodeficiency virus (HIV), which causes a viral infection to attack the immune system cells, making one even more susceptible to other infections and diseases. As such, diabetes patients are often affected by HIV infection since they have a severely weakened immune system.
HIV does not have a cure but highly active antiretroviral therapy (HAART), a unique combination of medications used to combat the virus can keep it under control. HAART also helps increase the life expectancy of HIV patients significantly. However, HIV and some HAART medications may also increase one’s chances of getting diabetes or getting it at a younger age. A 2021 study shows up to 15 per cent of HIV patients have diabetes.
Since both these conditions directly affect the immune system, they further raise the risk of metabolic disorders such as insulin resistance, impaired glucose, metabolic syndrome, elevated lipids, and obesity. As a result, persons with HIV and diabetes are at a higher risk of developing heart disease, peripheral vascular disease, and strokes, too. Additionally, opportunistic infections are more common in people with diabetes due to it being an immune-suppressed disease, necessitating a multidisciplinary approach to treating diabetics who also have HIV.
How does HIV increase the chances of developing diabetes?
Studies show that people with HIV develop diabetes at a younger age than the general population.
Estimates of the prevalence of diabetes among people living with HIV vary depending on factors such as participant age and location. One widely cited study estimates that people with HIV are four times more likely to have diabetes than the general population, while a more conservative estimate is that people with HIV over the age of 50 have a 1.39 times higher risk of diabetes than people of the same age without HIV.
HIV and diabetes treatment
Improved HIV detection methods, earlier diagnosis, and better management have contributed to patients’ improved survival. Because of the availability and accessibility of effective antiretroviral therapy, people living with HIV can live almost normal lives. As a result, the number of chronic HIV complications encountered in clinical practice has increased.
Although people with HIV may have a poorer response to diabetes medications, some medications may interact with HIV medications, so it’s critical to keep in touch with your doctor regularly. As a result, people living with HIV frequently present with diabetes and metabolic issues.
How can people living with HIV reduce their risk of developing diabetes?
Overweight people, those who rarely exercise, and those with a family history of diabetes are more likely to develop diabetes. Infection with the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV), high blood pressure, high cholesterol, medication side effects, and current pregnancy are all risk factors. While smokers are 30-40 per cent more likely to develop type 2 diabetes, people of certain ethnicities may be more susceptible too.
By making some lifestyle and dietary changes, you may be able to prevent the development of diabetes. Try to:
*Consume a well-balanced diet that is low in refined sugar, salt, and fat
*To avoid excess sugar, drink water or other calorie-free beverages as primary beverages
*30 minutes of moderate regular exercise is essential
*Maintain a healthy weight
*Check blood sugar levels on a regular basis while on HIV medications and before beginning treatment
*Quit smoking or avoid starting if you don’t already
The bottom line
Diabetes is generally seen as a lifestyle illness, affecting largely the elderly. As a result of the benefits of antiretroviral medication, people living with HIV are becoming increasingly vulnerable to diabetes (ART).
The best strategy to avoid diabetes is to restrict or eliminate the risk factors under your control, such as eating a balanced diet and keeping a healthy weight, exercising regularly, and quitting smoking. It is advised that seniors have their blood sugar levels monitored regularly. If levels are high, reducing weight may result in improvement, especially in obese people.
(The author is director of the Internal Medicine department at Fortis Hospital, Bannerghatta Road, Bengaluru)