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Do people with HIV at greater risk of diabetes?

HIV (Human Immunodeficiency Virus) is a virus that targets immune system cells, rendering a person more susceptible to various illnesses and infections. HIV can be acquired through unprotected sex (sex without the use of a condom or HIV medication to prevent or treat HIV), sharing injectable supplies, or other means of coming into touch with certain body fluids of an HIV-positive individual. 


Leaving this untreated illness increases the risk of developing AIDS or acquired immunodeficiency syndrome. Since there is no effective treatment for HIV and no method for the human body to get rid of it, once you have the disease, you will always have it. However, there are HIV medications that work, such as ART or antiretroviral therapy. Drugs used in antiretroviral therapy operate by preventing the virus's growth inside the body. It enables the immune system to heal itself and stop additional damage, according to NHS UK. 


HIV medications have the ability to significantly lower the viral load, another name for the amount of HIV in the blood if taken as directed. According to the HIV government, people can live long, healthy lives and will not transmit HIV to their HIV-negative partners through sex as long as they take their HIV medications as directed and maintain an undetectable viral level. But how are HIV and diabetes-related? Read this article to learn more. 


Do people with HIV at greater risk of diabetes?


Yes, people with HIV have a greater risk of developing diabetes than people without it. Diabetes is a common health problem, and many people who are diagnosed with certain conditions can eventually develop it. Some of these factors are; having diabetes in your family, being overweight, and being older. Because of better diagnosis and treatment made for HIV, people with HIV live longer today, and more of them are developing diabetes for the same reasons other people do. 


Some HIV medications have the side effect of high blood sugar. Diabetes and hyperglycemia are risks for those who use some of these medications. In addition to weight gain being a side effect of several HIV medications, diabetes can also develop in HIV patients due to weight gain. Hepatitis C infection is common among HIV patients, and it has been linked to diabetes. As a side effect of the virus, HIV patients also experience inflammation, which has been linked to diabetes development. 


One article also stated that people with HIV tend to develop diabetes at a younger age than the general population. Researchers suggest that while the ART treatment improves the overall quality of a patient who is diagnosed with HIV, it may increase the risk of diabetes and prediabetes. Some HIV medications can negatively affect how your body controls and manages sugar. This instance can lead to insulin resistance and interfere with your pancreas secreting insulin. 


After taking these drugs, some people are more likely to develop diabetes. Risk elements consist of:


  • Having diabetes in the family
  • Gaining weight
  • Greater age
  • Hepatitis C.
  • Some HIV-positive individuals experience lipodystrophy, alterations in their body's fat distribution

A 2022 article from the Aidsmap also stated that women with HIV are at greater risk of developing diabetes than men


Should people with HIV get tested for diabetes?


Yes, persons with HIV should have their blood sugar levels checked since they have a higher possibility of developing diabetes, and it's preferable if they find out sooner rather than later so they can avoid other harmful illnesses. Before beginning treatment with HIV medications, they should have their blood glucose checked. HIV medications that interact poorly with diabetic treatments should be avoided in persons with higher-than-normal glucose levels.


Following the initiation of HIV medications, blood glucose measurement is also crucial. If testing reveals elevated glucose levels, it might be essential to adjust HIV medication.


Treatments


Before starting HIV therapy, experts advise persons with HIV to have their blood sugar levels examined. In order to keep your blood sugar at a healthy level and stop the disease from wreaking additional havoc on your body, your doctor may recommend routine blood sugar checks. Some common diabetes medications, including metformin, are expected to continue to regulate blood sugar. But it's possible that people with HIV will react to diabetes medications differently than persons without HIV.  


HIV-positive individuals with diabetes receive comparable treatment recommendations to those without HIV. However, those who have HIV could respond to diabetes treatments less favorably. Some blood-sugar-lowering drugs may negatively interact with HIV treatment regimens, leading to weight gain and other side effects. Some persons with type 2 diabetes also require daily insulin injections, but not all of them do.


Work with your healthcare provider to reduce these risks and identify the HIV and diabetes treatment options that will work best for you. While taking HIV medicine, remember to routinely check your blood sugar level to see whether you need to switch medications. It is also advisable to create a strategy for a balanced diet and exercise that will help you lose weight and, if successful, regulate your diabetes. Some people's diabetes may enter remission as a result of weight loss and a good diet. This indicates that they don't require diabetes medication because their blood sugar levels stay within a normal range.


GPs, specialized nurses and specialized nutritionists are among the healthcare professionals involved in controlling diabetes. A diabetologist or endocrinologist may be a medical professional with a focus on diabetes (a doctor who treats disorders of the glands and hormones, including diabetes). They will advise you on your course of therapy and the best course of action moving forward.


Diagnosis and monitoring


To evaluate your blood's level of glucose, your doctor should perform a blood test once a year. The hemoglobin A1c test provides a mean estimate of your 12-week average glucose levels. Your blood glucose level will be shown to be normal, greater than usual, or at a level that indicates you have diabetes. For those who have been diagnosed with HIV, the results of this test may vary, and their therapy may also involve taking other drugs. When interpreting the test results, your healthcare professional will keep this in mind.


The fasting glucose test is an additional diabetes diagnostic procedure. You must refrain from eating or drinking anything other than water for eight to ten hours before this straightforward blood test. In addition to giving you a flash or continuous glucose monitor, your doctor could instruct you to perform daily blood glucose tests at home. A tiny amount of blood is drawn through a finger prick and placed on a hand-held meter given by the NHS for daily blood glucose testing. Small, under-the-skin devices called flash, or continuous glucose monitors are typically worn on the arm or belly.



HIV in type 1 and type 2 diabetes


An autoimmune disorder called type 1 diabetes occurs when the body assaults the cells that make insulin. After receiving an HIV diagnosis, type 1 diabetes can very rarely develop in some persons. Nobody is aware of the cause of this. Sexually transmitted infections and other severe illnesses might make it harder to control your blood sugar levels if you have type 1 diabetes. This may result in a potentially fatal complication known as diabetic ketoacidosis if it is not managed.


A disorder in the body's ability to control and utilize sugar (glucose) as fuel is type 2 diabetes. Due to its characteristics, type 2 diabetes is frequently linked to HIV because people are much more likely to get it. High blood sugar levels might make a person's immune system less effective, according to the APIC (Association for Professionals in Infection Control and Epidemiology). Long-term diabetics may experience peripheral nerve loss, decreased blood supply to the limbs, and an increased risk of infection.


How can a person prevent or manage type 2 diabetes?


Preventing type 2 diabetes can let you have a strong immune system that can fight infections and viruses, and if you have type 2 diabetes, you can already manage it to prevent the development of other complications that can also affect HIV. According to the aidsmap, you can take the following steps to lower your risk of developing type 2 diabetes:


  • Lose weight. This is especially crucial if you carry extra weight in your midsection because diabetes risk increases with larger waist measurements. Aim to maintain a weight that is within the range recommended for your height, age, and sex. You can learn more about this range from your doctor, nurse, or dietician. A modest weight loss can have a significant impact.

  • Exercise regularly. At least 150 minutes per week of moderate aerobic exercise should be your goal (for example, 30 minutes five days a week). Your heart rate will increase with moderate exercise, and you'll also feel warmer and breathe more quickly. It consists of things like brisk walking, dancing, gardening, and cycling. Additionally, performing certain muscle-strengthening workouts is advised (lifting weights or doing exercises that use your own body weight like yoga or Pilates). Alternatively, make sure you take 10,000 or more steps each day.

  • Eat a healthy, balanced diet. It is advised to have a diet rich in vegetables, legumes, and whole grains, similar to the Mediterranean diet. Replace moderate amounts of red meat with chicken and fish. Limit your intake of refined sugar-rich foods and beverages. Planning your dinner around veggies rather than meat, grains, or pasta may make this easier. You should eat most foods with a low glycaemic index or those that only gradually raise blood glucose levels if you have been diagnosed with type 2 diabetes. Additionally, you must monitor your intake of starchy foods (carbohydrates) in order to maintain healthy blood sugar levels.

There are also other steps you can do to prevent or manage type 2 diabetes:


  • Drink water or other calorie-free drinks as your primary beverages to avoid excessive sugar.

  • Check your blood sugar levels regularly while taking HIV medications and before starting treatment.

  • Quit smoking, or avoid starting if you don't currently smoke.

People who have type 2 diabetes can also follow these steps to manage the disease. If you have HIV talk to your healthcare provider first about the medications, you'll take because these might interact negatively with your diabetes medications. 


Why drug interactions happen with ART


When two or more medications are taken at the same time or very close together, a drug interaction occurs. One, all, or none may not be as efficient. Or you could have negative effects from the mix. Drug interactions can occur in a variety of ways. Drug interactions with ART can be minor, moderate, or severe.


According to WebMD, your body's ability to metabolize, absorb and process your ART medications is greatly influenced by an enzyme known as CYP3A. It also has an impact on any additional medications you may be taking. Some of these medications may prevent CYP3A and other enzymes from properly metabolizing your medications. The number of active chemicals in your therapies may decrease or increase as a result of this.


Does having diabetes with HIV lower my life expectancy?


Additionally, it appears that HIV-positive individuals have increased risks of diseases like heart disease, diabetes, osteoporosis, and renal disease that are normally linked to aging. HIV alone may not be as effective at preventing diabetes as HIV together. Treatment is offered for both disorders, though. According to a US study, HIV-positive individuals typically experience serious illnesses 16 years earlier than HIV-negative individuals.


Only HIV-positive individuals survived almost 1.5 years longer than HIV-positive individuals who also had diabetes and almost five years longer than HIV-positive individuals who also had chronic renal disease. To stop complications from developing and to reduce the progression of diabetes, seek treatment as soon as you can.

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