(Last updated 11/17/2016; last reviewed 11/17/2016)
Diabetes is a disease in which levels of blood glucose (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy.
Diabetes can cause serious health problems, including heart and blood vessel disease, nerve damage, blindness, stroke, and kidney disease. Fortunately, diabetes can be controlled with diet, exercise, and medicines.
Glucose is carried in the blood to cells throughout the body. A hormone called insulin helps move the glucose into the cells. Once in the cells, glucose is used to make energy. When the body has trouble moving glucose into the cells, glucose builds up in the blood and can lead to diabetes.
There are two main types of diabetes: type 1 diabetes and type 2 diabetes.
In type 1 diabetes, the body’s immune system attacks and destroys the cells that produce insulin. Lack of insulin causes glucose to build up in the blood.
In type 2 diabetes, the body can't produce enough insulin or use it effectively to move glucose into the cells. Type 2 diabetes is more common than type 1 diabetes.
Risk factors for type 2 diabetes include age over 45, a family history of diabetes, being overweight, and lack of physical activity. People whose family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American are at greater risk of type 2 diabetes.
In people with HIV, the risk of type 2 diabetes is greater in people who are also infected with hepatitis C. Additionally, the use of some HIV medicines in the nucleoside reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) drug classes may increase blood glucose levels and lead to type 2 diabetes. These HIV medicines seem to make it harder for the body to respond to and use insulin (insulin resistance). Insulin resistance leads to high blood glucose levels, which can result in type 2 diabetes.
The symptoms of diabetes can include:
A common test used to diagnose diabetes is the fasting plasma glucose (FPG) test. The FPG test measures the amount of glucose in the blood after a person has not eaten for 8 hours.
People with HIV should have their blood glucose levels checked before starting treatment with HIV medicines. People with higher-than-normal glucose levels may need to avoid taking some HIV medicines.
Blood glucose testing is also important after starting HIV medicines. If testing shows high glucose levels, a change in HIV medicines may be necessary.
Type 2 diabetes can often be controlled with a healthy diet and regular exercise. A healthy diet and daily exercise can help a person reach and maintain a healthy weight.
A healthy diet includes lots of vegetables, some fruit, beans, whole grains, and lean meats and is low in processed foods high in sugar and salt. To learn more, read this webpage from the Centers for Disease Control and Prevention (CDC) on healthy eating.
Regular exercise means being active for 30 minutes on most days of the week.
Sometimes, in addition to a healthy diet and regular physical activity, medicines are needed to control type 2 diabetes. (Treatment for type 1 diabetes always includes taking insulin.)
People with HIV who have diabetes may need to avoid taking some HIV medicines and use other HIV medicines instead.
If you have HIV, ask your health care provider about the link between HIV medicines and diabetes. You can also talk to your health care provider about your risk of diabetes and your options for testing.