Prevalence and Risk Factors for Diabetes Mellitus among newly-diagnosed HIV-infected South African Adults
Year: 2017
Type: dissertation
Study design: Observational Study
Abstract: Background: Non-communicable diseases and their risk factors, including diabetes mellitus, have been increasing in HIV-endemic resource-limited settings.We sought to determine the prevalence and risk factors for diabetes in HIV-infected South African adults. Methods:We conducted a cross-sectional study of newly diagnosed HIV-infected adults in a poor urban township in KwaZulu-Natal, South Africa.We used indicators for demographic, socioeconomic, and substance use prior to HIV testing.We defined diabetes as having a hemoglobin A1c (HbA1c) ≥6.5% or in the absence of this test, a random blood glucose (RBG) ≥11.1 mmol/L, and prediabetes was defined as HbA1c 5.7-6.4% or RBG 7.8-11.1 mmol/L.We used logistic regression to identify risk factors for prediabetes or diabetes.Results: Among 1,048 HIV-infected adults, mean age was 33 years, 630 (60.1%) were female, and 253 (24.2%) were obese.The prevalence of diabetes and prediabetes were 2.8% and 7.4%, respectively.In the multivariate model, age 45 years or older (8.50 OR, 95% CI: 3.27-22.07),BMI greater than 30 kg/m 2 (23.60 OR, 95% CI: 11.41-48.85),female sex (2.20 OR, 95% CI: 1.39-3.48),greater than 5 kilometers from a clinic (1.98 OR, 95% CI: 1.11-3.55),hypertension (2.64 OR, 95% CI:1.55-4.49),CD4 cell counts >350 (1.97 OR, 95% CI:1.06-3.67)and cigarettes use (0.34 OR, 95% CI: 0.15-0.76)were associated with a higher odds of diabetes or prediabetes.None of the 1,048 participants who had either pre-diabetes or diabetes were aware of their diagnosis or reported receiving diabetic treatment.Conclusions: The prevalence of prediabetes or diabetes was over 10% among newly diagnosed HIV-infected adults in South Africa, and none of these adults were aware of their condition or receiving therapy.Screening may target those who are obese, live farther away from a clinic, older age, have hypertension, have higher CD4 counts and females, while treatment for diabetes needs to be expanded among all HIV-infected adults.
Author: Joseph Murphy
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: Massachusetts General Hospital, Vanderbilt University, Harvard University, Harvard University Center for AIDS Research, Harvard Global Health Institute, National Institutes of Health, Center for AIDS Research, University of Washington, National Institute of Allergy and Infectious Diseases, Fogarty International Center
Awards: G1575283533, G1722716446, G2156422577, G345173699, G346640147, Clinic-based Screening to Prevent HIV-associated Cryptococcal Mortality, Fogarty International Clinical Research Scholars Support Center @ Vanderbilt-AAMC, G7785852513, G7828394300, Program for AIDS Clinical Research Training (PACRT), Harvard University Center for AIDS Research
OpenAlex ID: W2750235457