<--GAT-->

Veterans with HIV Responsive to Standard Diabetes Therapy

by U.S. Medicine

February 14, 2017

PHILADELPHIA—With Type 2 diabetes  increasingly common in HIV-infected individuals, are standard oral diabetes medications as effective in that population?

That was the concern explored in a study published in the journal Diabetes Care. University of Pennsylvania researchers and colleagues compared glycemic effectiveness of oral diabetic medications among patients with and without HIV infection.1

The VA Greater Los Angeles Health Care System, the Atlanta VAMC and the  Michael E. DeBakey VAMC in Houston participated in the longitudinal cohort study of HIV-infected and uninfected veterans with Type 2 diabetes initiating diabetic medications between 1999 and 2010.

Generalized estimating equations were used to compare changes in hemoglobin A1c (HbA1c) through the year after medication initiation, adjusting for baseline HbA1c level and clinical covariates the 2,454 HIV-infected patients and 8,892 HIV-uninfected patients initiating diabetic medications during the study period.

Half the patients were prescribed metformin, while nearly half received a sulfonylurea  and the remaining were prescribed a thiazolidinedione.

Results indicate that, after adjustment for potential confounders, no significant difference was detected in the change in HbA1c level among the three groups of new users. Furthermore, HIV infection was not significantly associated with glycemic response.

The study found that black and Hispanic patients had a poorer response to therapy compared with white patients, with a relative increase in HbA1clevel of 0.16% and 0.25%, respectively.

“We found that glycemic response was independent of the initial class of diabetic medication prescribed among HIV-uninfected and HIV-infected adults with Type 2 diabetes,” study authors conclude. “The mechanisms leading to poorer response among black and Hispanic patients, who comprise a substantial proportion of those with HIV infection and Type 2 diabetes, require further investigation.”

  1. Han JH, Gordon K, Womack JA, Gibert CL, Leaf DA, Rimland D, Rodriguez-Barradas MC, Bisson GP. Comparative Effectiveness of Diabetic Oral Medications Among HIV-Infected and HIV-Uninfected Veterans. Diabetes Care. 2016 Sep 15. pii: dc160718. [Epub ahead of print] PubMed PMID: 27634393.

Comments are closed here.


Related Articles

Caution Urged in Use of Sulfonylureas in Some T2 Diabetes Patients with CAD

VA clinicians should exercise caution with use of sulfonylurea in some patients with co-morbid type 2 diabetes and cardiovascular disease, according to new research.

Hypoglycemia Concerns Help Drive Use of Continuous Glucose Monitoring at VA

As the VA increases its focus on minimizing hypoglycemia in veterans with type 2 diabetes, it expects that more physicians and veterans will consider using continuous glucose monitors to meet that goal.


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

Senate VA Committee Chair Vows to Pass 'Blue Water' Navy Benefits

Senate Committee on Veterans' Affairs Chairman Sen. Johnny Isakson (R-GA) vowed that addressing benefits for Blue Water Navy Veterans “is no longer going to be a question,” but that “how we do it is the only question.”

Department of Veterans Affairs (VA)

VHA Makes Progress in Improving Safety of Opioid Prescribing

VHA medical facilities should ensure that its providers are following three key opioid risk mitigation strategies, including conducting urine drug screening, a recent report recommended.

Department of Veterans Affairs (VA)

VA faces healthcare staffing shortages, barriers to hiring facility leaders

A facility-specific survey found that 138 of 140 VA facilities reported shortages of medical officers, with psychiatry and primary care positions being the most frequently listed.

Department of Veterans Affairs (VA)

Veteran nephrologist labors to improve ESRD treatment at VA

When Terrence O’Neil, MD, retired as chief of nephrology at the James H. Quillen VAMC in Johnson City in December 2016, he left in his wake decades of work treating kidney disease—nearly 35 years in the Air Force and DoD, plus 11 more at VA.

Department of Veterans Affairs (VA)

Committee approves bill to provide agent orange benefits to ‘blue water’ vets

A long sought-after bill that would make it easier for Blue Water Navy veterans to receive Agent Orange benefits has been passed by a key House of Representatives committee.

Subscribe to U.S. Medicine Print Magazine

U.S. Medicine is mailed free each month to physicians, pharmacists, nurse practitioners, physician assistants and administrators working for Veterans Affairs, Department of Defense and U.S. Public Health Service.

Subscribe Now

Receive Our Email Newsletter

Stay informed about federal medical news, clinical updates and reports on government topics for the federal healthcare professional.

Sign Up