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Diagnosis, risk factors and management of diabetes mellitus in HIV-infected persons in France: A real-life setting study.

Authors
  • Kousignian, Isabelle1
  • Sautereau, Aurélie2, 3
  • Vigouroux, Corinne4, 5
  • Cros, Agnès2, 6
  • Kretz, Sandrine7
  • Viard, Jean Paul2, 8
  • Slama, Laurence2
  • 1 Unité de Recherche « Biostatistique, Traitement et Modélisation des données biologiques » BioSTM-UR 7537, Université de Paris, Paris, France. , (France)
  • 2 Department of infectious diseases, Assistance Publique-Hôpitaux de Paris, Hôtel Dieu Hospital, Paris, France. , (France)
  • 3 Department of infectious diseases, Assistance Publique-Hôpitaux de Paris, Bichat Hospital, Paris, France. , (France)
  • 4 Sorbonne Université, Inserm UMR S 938, Saint-Antoine Research Center, University Hospital Institute of Cardio-metabolism and Nutrition (ICAN), Paris, France. , (France)
  • 5 Departments of Endocrinology and of Molecular Genetics, Assistance Publique-Hôpitaux de Paris, Saint-Antoine Hospital, National Reference Centre of Rare Diseases of Insulin Secretion and of Insulin Sensitivity (PRISIS), Paris, France. , (France)
  • 6 COREVIH Ile de France Sud, Hôpital Henri Mondor, Creteil, France. , (France)
  • 7 Centre de Diagnostic et de Thérapeutique, Hôpital Hôtel Dieu, Paris, France. , (France)
  • 8 CNRS 8104/INSERM U1016, Institut Cochin, Université de Paris, Paris, France. , (France)
Type
Published Article
Journal
PLoS ONE
Publisher
Public Library of Science
Publication Date
Jan 01, 2021
Volume
16
Issue
5
Identifiers
DOI: 10.1371/journal.pone.0250676
PMID: 33990121
Source
Medline
Language
English
License
Unknown

Abstract

Diabetes mellitus (DM) is a major and increasing public health problem that may be underdiagnosed and undertreated among persons living with HIV (PLWH). To describe the diagnosis, treatment and follow-up of DM among PLWH. This study was performed inside a monocentric cohort of 1494 PLWH. DM was defined as having a FG ≥126 mg/dL twice or a HbA1c ≥6.5%, or a history of diabetes, or receiving antidiabetic treatment. The first visit mentioning a diagnosis of DM was considered as the baseline visit. Chi-Square or Fisher exact test were used to examine the association between categorical variables and DM, Wilcoxon or Student t-test were used for continuous variables. 156 PLWH with DM were included. Compared to non-diabetic participants, they were more likely to be native of Sub Saharan Africa (31.6% vs. 22.4%, p = 0.027) and older (54.6 vs. 49.9 years, p<0.001), to have a higher BMI (> 25 for 46.1% vs. 35.3%, p = 0.020) and a poorer control of HIV (HIV RNA<50 copies/mL: 80.1% vs. 89.5%, p<0.001). The diagnosis of DM was missed in 37.8% of PLWH, and 47.2% of PLWH treated for DM did not reach a HbA1c<7%. PLWH with DM were more frequently on antihypertensive and/or lipid-lowering medications: 94.2% had a LDL-cholesterol <70 mg/dL and 60.9% had a blood pressure <140/90 mmHg. In a setting of HIV-control, HIV care providers should focus on metabolic issues. The management of DM and associated risk factors is mandatory to prevent cardiovascular disease in PLWH.

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