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HIV and Diabetes

Medically Reviewed by Jonathan E. Kaplan, MD on May 08, 2022

People living with HIV are more likely to get diabetes than people without it. One study showed that diabetes was up to four times more common in people with HIV.

Diabetes is a common health problem. Many things make you more likely to get it, including having diabetes in your family, being overweight, and being older. But some people with HIV get diabetes at younger ages and without being overweight.

Why There Is an Increased Risk

One reason more people have HIV and diabetes now is that better diagnosis and treatment of HIV means that people with this infection are living longer today. As people with HIV live longer, more of them are getting diabetes for the same reasons other people do. Some estimates show that on average, people treated for HIV early can live nearly as long as people without HIV.

But some things make diabetes more likely for people with HIV.

High blood sugar is a side effect of some medicines that treat HIV. Doctors call high blood sugar hyperglycemia. Though people with uncontrolled diabetes also have high blood sugar, you can have high blood sugar without having diabetes. But people taking some of these medicines may be at greater risk for both hyperglycemia and diabetes. Newer HIV medicines don’t seem to come with the same risk.

Some medicines used to treat HIV may cause people to gain weight. Because weight gain increases the risk for diabetes, this may put people with HIV at more risk.

Many people with HIV have also have a hepatitis C infection. Hepatitis C has been linked to diabetes.

People with HIV have inflammation as a result of the infection. This inflammation may play a role in the development of diabetes.

What It Means for Treatment

Experts recommend that people with HIV get their blood sugar checked before beginning treatment for HIV. Your doctor may want to check your blood sugar regularly to make sure it’s at a healthy level.

If you have HIV and high blood sugar or diabetes, it may affect your treatment. People with high blood sugar may need to avoid certain HIV medicines. Some common drugs for diabetes such as metformin will likely still control blood sugar. But people with HIV might not respond to diabetes treatment in the same way that people without HIV do.

Some medicines used to lower blood sugar may also interact with treatments used to control HIV and may cause weight gain or other unwanted effects. Work with your doctors to curb these risks and find a combination of treatments that works for you.

Diabetes Prevention

If you have HIV and are worried about diabetes, it’s a good idea to talk to your doctor about this risk and what you can do to protect your health. The best way to prevent or delay diabetes is to take care of yourself by eating right, exercising, and taking your medicines as prescribed.

Show Sources

SOURCES:

Diabetes Research Institute Foundation: “Diabetes Statistics.”

Archives of Internal Medicine: “Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study.”

PLoS One: “Type 2 diabetes prevalence and its risk factors in HIV: A cross-sectional study.”

BMJ Open Diabetes Research & Care: “Is diabetes prevalence higher among HIV-infected individuals compared with the general population? Evidence from MMP and NHANES 2009–2010.”

San Francisco AIDS Foundation: “Life expectancies close to 80 years for young people starting HIV meds early.”

Endotext: “Diabetes in People Living with HIV.”

Journal of Acquired Immune Deficiency Syndromes: “Weight Gain and Incident Diabetes among HIV Infected-Veterans Initiating Antiretroviral Therapy Compared to Uninfected Individuals.”

AIDSinfo: “Side Effects of Anti-HIV Medications.”

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