Prevalence of impaired fasting glucose and diabetes mellitus among HIV infected individuals on anti-retroviral therapy at the Adult Infectious Disease Centre, Lusaka

Abstract

Background: Traditional host factors and treatment related metabolic changes are implicated in the increase of impaired glucose levels and Type 2 diabetes mellitus in HIV patients. Diabetes mellitus has specific morbidity and mortality consequences. It also contributes to the burden of other non-communicable and communicable diseases. In HIV patients it could further contribute to ill health and present new challenges for therapeutic management of HIV/AIDS. As new HIV guidelines are implemented and scale up of ART programs takes effect, the number of individuals on lifelong therapy is bound to increase and potentially the incidence of impaired glucose levels and Type 2 diabetes mellitus in this population. Objective: To determine the prevalence and risk factors associated with impaired fasting glucose and Type 2 diabetes mellitus amongst HIV infected individuals on antiretroviral drugs at the Adult Infectious Disease Centre, Lusaka. Methods: A cross sectional study included HIV infected individuals accessing care and receiving antiretroviral therapy at the Adult Infectious Disease Centre (AIDC), University Teaching Hospital in Lusaka. Eligible participants presenting to facility for scheduled follow up visits were consecutively enrolled. A modified WHO global surveillance initiative NCD-STEP 3 method was adapted for data collection to determine point prevalence of impaired fasting glucose and Type 2 diabetes mellitus. Diabetes mellitus and impaired fasting glucose were defined per WHO 2006 diagnostic criteria as fasting blood sugar concentration of ≥ 7.0 mmol/L and ≥ 6.1 to ≤6.9 mmol/L respectively. Data was analysed using STATA version 12 and cross tabulations utilized to assess relationship between impaired fasting glucose, diabetes mellitus and explanatory variables. Categorical data were compared using chi-square test and expressed as proportion with a 95% confidence interval. Results: Of the 224 participants in the survey, 56.7% were females. 71% of the participants were of age 20-45 years. Twenty 20 (8.9%) participants (12 females and 8 males) had impaired fasting glucose, while 4 (1.8%) participants (all males) had diabetes mellitus, giving an overall prevalence of impaired glucose level of 10.7%. It was also found that 28.1 % of the participants were overweight while 15.2% were obese. Body Mass Index and age were associated with Impaired Fasting Glucose and Type 2 Diabetes Mellitus. Conclusion: There is a significant prevalence of dysglycemia among HIV infected patients on ART accessing care at AIDC in UTH, Lusaka. Dysglycemia is a potential threat to HIV infected persons and likely influenced by a host of factors. Regular monitoring and screening for hyperglycemia is imperative for early diagnosis, prevention and treatment of impaired glucose levels/ Type 2 diabetes mellitus to minimize incidence and severity of acute and long term complications and avert premature mortality.