HIV (human immunodeficiency virus) infected patients are prone to other diseases. This guide will suggest how you can prevent l Type 2 diabetes and diabetes progress in HIV infected patients based on several factors, such as diet, weight control, nutrition plan, and exercise.
To begin with, it is recommended for clinicians to assess risk factors for Type 2 diabetes in HIV patients at baseline annually. The risk factors include PI(protease inhibitor) use, severe body fat changes, Hepatitis C infection, Age ≥45 years, Overweight (BMI ≥25 kg/m²), Habitua, physica, inactivity, First-degree relative with diabetes, Specific racia, or ethnic groups, African American, Latino, Native American, Asian American, Pacific Islander, Previously identified glucose metabolism disturbance (e.g., IGT (impaired glucose tolerance) or IFG (impaired fasting glucose ) on previous testing), History of vascular disease, Blood pressure ≥140/90 mmHg, High-density lipoprotein cholestero, (HDL-C) 35 mg/dL, Triglycerides >250 mg/dL, History of gestationa, diabetes or delivery of infant >9 lbs, and Polycystic ovary syndrome or acanthosis nigricans.
Secondly, appropriate diet, nutrition plan, weight control, and exercise should be properly emphasized to avoid type 2 diabetes developments.
Thirdly, it is necessary for clinicians to assess fasting blood glucose before initiating HAART (highly active antiretroviral therapy), 3-6 months after initiation, and at least yearly afterward.
Fourthly, clinicians should order 75 g of oral glucose (2-hour glucose tolerance test) to differentiate between impaired glucose tolerance (glucose level ≥140 mg/dL 2 hours after oral glucose) and diabetes (glucose level ≥200 mg/dL after oral glucose) in patients with repeated borderline fasting glucose values.
In addition, there are some key points to consider. Random blood glucose values may be used as an alternative screening method if fasting blood glucose tests are not feasible. Patients with random glucose consistently <100 mg/d, do not require follow-up testing. A random glucose >140 mg/d, should prompt use of a standardized diagnostic test, such as a glucose tolerance test. A random plasma glucose ≥200 mg/dL, either repeated on a subsequent day or in the presence of unequivoca, symptoms of hyperglycemia (e.g., serum glucose >400 mg/dL, lactic acidosis, smal, to moderate amounts of ketones, serum pH of <7.3, bicarbonate of <15 mEq/L, anion gap >12), meets the threshold for the diagnosis of diabetes.
Prevention of Diabetes Disease Progression
- Clinicians who lack experience in treating diabetic patients should refer patients for evaluation by clinicians experienced in managing diabetes.
- When possible, clinicians should prescribe alternatives to a protease inhibitor-based HAART regimen in patients with preexisting glucose intolerance or diabetes.
- Clinicians should recommend life-style interventions, including diet, exercise, weight management, and smoking cessation, for HIV-infected patients with glucose intolerance or diabetes.
- When possible, HIV-infected patients with diabetes should develop and maintain a nutrition plan with a qualified nutrition counselor.
- Clinicians should refer diabetic patients who are not responsive to medica, intervention or who have symptoms and signs of worsening diabetes to an endocrinologist.
