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

Genetic Mutations Affecting Response to Drugs Are Common in Veterans

VA Debates Who Should Receive Pharmacogenetic Testing SALT LAKE CITY—A massive VA study revealed that 99% of veterans have at least one genetic mutation known to affect response to specific drugs, including some commonly prescribed... View Article

Year Supply of Contraceptives Prevents More Unintended Pregnancies

Birth Control Pill Change Could Save VA $2 Million Annually PITTSBURGH—What if there was a method to prevent nearly 600 unintended pregnancies and save the VA about $2 million a year in prenatal, birth and... View Article


U.S. Medicine Recommends


More From department of veterans affairs

Department of Veterans Affairs (VA)

Genetic Mutations Affecting Response to Drugs Are Common in Veterans

VA Debates Who Should Receive Pharmacogenetic Testing SALT LAKE CITY—A massive VA study revealed that 99% of veterans have at least one genetic mutation known to affect response to specific drugs, including some commonly prescribed... View Article

Department of Veterans Affairs (VA)

Year Supply of Contraceptives Prevents More Unintended Pregnancies

Birth Control Pill Change Could Save VA $2 Million Annually PITTSBURGH—What if there was a method to prevent nearly 600 unintended pregnancies and save the VA about $2 million a year in prenatal, birth and... View Article

Department of Veterans Affairs (VA)

Feds Investigate 11 Unexplained Deaths at West Virginia VAMC

CLARKSBURG, WV – Law enforcement officials announced recently that a criminal investigation has been launched to look into the unexplained deaths of as many as 11 patients at the Louis A. Johnson VA Medical Center... View Article

Department of Veterans Affairs (VA)

VA Pathologist Indicted In Connection Veteran Deaths in Arkansas

Investigators Say Impaired Clinician Recorded Wrong Diagnoses FAYETTEVILLE, AR – A physician employed by the Veterans Health Care System of the Ozarks here was indicted by a federal grand jury on a range of charges,... View Article

Department of Veterans Affairs (VA)

GAO: VA Still Lags in Ability to Track Veteran Wait Times for Care

WASHINGTON—Five years after scandal rocked the VA, the agency still does not have a reliable way of tracking patient wait times according to a recent Government Accountability Office report. In 2014, whistleblowers at the Phoenix... View Article

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