Side Effects of HIV Medicines
HIV and Diabetes
Last Reviewed: August 29, 2018
- Diabetes is a disease in which levels of glucose in the blood (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy. There are two main types of diabetes: type 1 diabetes and type 2 diabetes.
- People with HIV are more likely to have type 2 diabetes than people without HIV. Some HIV medicines may increase blood glucose levels and lead to type 2 diabetes. Other risk factors for type 2 diabetes include a family history of diabetes, being overweight, and lack of physical activity.
- People with HIV should have their blood glucose levels checked before they start taking HIV medicines. People with higher-than-normal glucose levels may need to avoid taking some HIV medicines and use other HIV medicines instead.
- 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 physical activity. Some people may also need to take medicines to control type 2 diabetes.
What is diabetes?
Diabetes is a disease in which levels of glucose in the blood (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy.
Over time, diabetes can cause serious health problems, including heart disease, stroke, kidney disease, eye problems, and nerve damage. Fortunately, diabetes can be controlled with diet, physical activity, and medicines.
How does diabetes develop?
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.
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.
What are the risk factors for type 2 diabetes?
Risk factors for type 2 diabetes include being 45 years of age or older, 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, Native Hawaiian, or Pacific Islander American are at greater risk of type 2 diabetes.
People with HIV are more likely to have type 2 diabetes than people without HIV. In people with HIV, the risk of type 2 diabetes is greater in people who also have hepatitis C.
Some HIV medicines in the nucleoside reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) drug classes may increase the risk of type 2 diabetes in people with HIV. 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.
What are the symptoms of diabetes?
The symptoms of diabetes can include:
- Unusual thirst
- Frequent urination
- Extreme hunger
- Unusual weight loss or weight gain
- Extreme fatigue and irritability
- Frequent infections
- Blurred vision
- Tingling or numbness in the hands and feet
- Slow healing of cuts or bruises
How is diabetes diagnosed?
The most common tests that are used to diagnose diabetes are the fasting plasma glucose (FPG) test and the A1C test. In some cases, a random plasma glucose (RPG) test may be used. Learn more about these tests on the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diabetes Tests & Diagnosis webpage.
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.
Can diabetes be treated?
Type 2 diabetes can often be controlled with a healthy diet and regular physical activity. A healthy diet and daily physical activity can help a person maintain a healthy weight. If you are overweight, you may be able to prevent or delay type 2 diabetes by losing weight.
If you have type 2 diabetes, follow these steps:
- Eat a variety of foods, including vegetables, fruits, whole grains, lean meats, beans, and nonfat or low-fat dairy products.
- Limit foods high in saturated fat, added sugars, and salt.
- Aim for at least 30 minutes of physical activity on most days of the week.
To learn more, read this webpage on Diabetes Diet, Eating, & Physical Activity from NIDDK.
Some people may also need to take medicines to control type 2 diabetes. (People with type 1 diabetes need to take insulin every day.)
If you have HIV, ask your health care provider about your risk of diabetes. You can also talk to your health care provider about the link between HIV medicines and diabetes. People with HIV who have diabetes may need to avoid taking some HIV medicines and use other HIV medicines instead.
This fact sheet is based on information from the following sources:
- From HHS: Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV: Adverse Effects of Antiretroviral Agents, Laboratory Testing, and Management of the Treatment-Experienced Patient: Poor CD4 Cell Recovery and Persistent Inflammation Despite Viral Suppression
- From the Department of Veterans Affairs: Primary Care of Veterans with HIV: Diabetes
- From the National Institute of Allergy and Infectious Diseases: A Helpful Guide to HIV and Metabolic Complications
- From NIDDK: Diabetes Overview
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