Clinical Topics   /   HIV

Less Diabetes Control in Non-adherence HIV Patients

By US Medicine

DURHAM, NC – Poor adherence to antiretroviral therapy in veterans with human immunodeficiency virus (HIV) also is a good predictor of whether those same patients will achieve good control if they have diabetes.

That’s according to a study from the Durham, NC, VAMC, and Duke University which found that veterans with higher viral loads and those less adherent to antiretroviral therapy were more likely to have a higher hemoglobin A1c.1

The report was published recently in the International Journal of STD & AIDS.

“Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age,” according to the authors, who explained that the purpose of the study was to assess the correlation between markers of HIV infection and diabetes and to determine the proportion of patients achieving an A1c goal less than 7%.

For the retrospective study, the researchers identified HIV-positive veterans with diabetes from 2007 to 2012. To be included in the review, patients were required to be on the same antiretroviral therapy and diabetes regimen for three months or longer.

Results indicated that, for each unit increase in log10 viral load, A1c increased 0.67 units (p = 0.0085). Only 38% of patients prescribed a protease inhibitor–based regimen vs. 56% of patients not on a protease inhibitor–based regimen achieved an A1c goal (p = 0.1864).

In addition, according to the study, patients on an insulin-based regimen and patients who were less adherent also were less likely to be at A1c goal (p = 0.018 and p = 0.0378, respectively).

“Patients with higher viral loads and patients that were less adherent to antiretroviral therapy were more likely to have a higher A1c, demonstrating that poor adherence to antiretroviral therapy leads to poor control of both disease states,” the authors concluded.

1 Davies ML, Johnson MD, Brown JN, Bryan WE, Townsend ML. Predictors of glycemic control among HIV-positive veterans with diabetes. Int J STD AIDS. 2014 May 14. pii: 0956462414535207. [Epub ahead of print] PubMed PMID: 24828555.

 


Related Articles

VHA Data Helps Validate Tool for Hypoglycemia Risk ID

OAKLAND, CA—Data from more than 1.3 million VHA patients was used to help validate a practical tool for identifying people with diabetes who are at the highest risk for being admitted to an emergency department... View Article

Hypoglycemia Common in Hospice Patients Continuing Insulin Treatment

BOSTON—Clinical guidelines recommend relaxing glycemic control target levels for patients with diabetes and advanced disease and eventual discontinuation of medications as patients near death to avoid hypoglycemia. A new study published in JAMA Internal Medicine... View Article


U.S. Medicine Recommends


More From diabetes

Diabetes

VHA Data Helps Validate Tool for Hypoglycemia Risk ID

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Diabetes

Hypoglycemia Common in Hospice Patients Continuing Insulin Treatment

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Diabetes

VA Study Shows Kidney Disease Ups Diabetes Risk

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Diabetes

VA Study Finds Older Medicare Patients Often Are Overtreated for Diabetes

It’s not only the VA that struggles with the balance between just enough treatment of older Type 2 diabetes patients and too much.

Diabetes

Metformin Shows Promise for Increasing NSCLC Survival

Vascular Events Lead to Stroke About a Fourth of the Time. INDIANAPOLIS — While many healthcare systems measure the quality of their stroke care, looking at performance early in the vascular disease process can help... View Article

Facebook Comment

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