Question
How bad is it to have diabetes and HIV together?
21 March 2012. Related: All topics, Complications and coinfections, Living with HIV long-term, Pregnancy.
I am a 30 years old woman .I have been HIV positive since 2009 and on combination treatment. Currently my viral load is undetectable and my CD4 count is above 500.
I just had a baby girl last month. I was diagnosed with gestational diabetes while pregnant.
Now that I have the baby, I have been asked to have a glucose tolerance test done to check whether it was just during the pregnancy or if I could be at risk of diabetes.
My question is being HIV positive, how bad it is to have diabetes also? And what types of treatment will I have be put on? Basically I would just like to know quite enough about the condition, just to be prepared.
Thank you.
Answer
First of all congratulations on the birth of your baby girl! I hope mother and baby are doing well.
Gestational diabetes is caused when pregnancy hormones block the production of insulin in the body. This leads to increased blood sugar levels. Most women see their blood sugar levels return to normal after delivery but for others these remain high. This is why you have now been asked to take a glucose tolerance test.
Some studies have shown that HIV positive women receiving antiretroviral treatment during may be at higher risk of gestational diabetes. This is an area that requires more study however as there have been conflicting results in different studies.
Even if your glucose levels have returned to normal following delivery there is still a chance you could develop diabetes. Unfortunately many women with gestational diabetes go on to develop diabetes 5-10 years after delivery. Some studies have also shown that people with HIV may be at higher risk of developing diabetes. For this reason it is important to remain conscious of your future blood sugar levels even if your next test shows they have returned to normal.
The positive news is that because there are relatively high numbers of people living with both HIV and diabetes there is a good level understanding around treatment.
You asked what type of treatments you would be likely to be put on. Many people are able to control diabetes through lifestyle changes such as increased exercise and weight loss. Healthy eating and stopping smoking are also important for diabetes treatment. HIV positive people with diabetes should see a specialist HIV dietitian for help with dietary changes. HIV dietitians can help balance any dietary requirements to do with ARV treatment with the needs of diabetic treatment.
Some ARVs are also implicated in causing increased glucose levels. Your doctor should review which ARVs you are receiving to see if these could be affecting your diabetes. Could you tell me which ARVs you are currently receiving?
Finally if diabetes cannot be controlled through changes in lifestyle changes or ARV changes treatment with diabetic drug therapy is recommended. For more information on the drug therapies used in treating diabetes alongside HIV please follow this link.
I just tested I’m hiv positive and I’m already a diabetic will it affect me to my coming drug to treat hiv? How can I control my diabetic while it’s been shooting very high.
Hi Thando,
Please see Q1 here:
http://i-base.info/qa/what-are-the-most-asked-questions
Hello. What I would like to know is, can I get hiv if I withdrawn insulin to inject myself from its container where a person who has diabetes and hiv has been withdrawing?
Hi Devontay,
If your boyfriend is on treatment then the risk of transmission is close to zero. Please see the results of the PARTNER study for more info:
http://i-base.info/qa-on-the-partner-study/
If he isn’t then your best option is to use condoms.
HIV and life expectancy is discussed in detail here:
http://i-base.info/qa/category/life-expectancy
Okay my boyfriend is HIV….positive….and I’m a diabetic……If I happen to get infection…..how long can I live?
Hi Alija,
You being positive isn’t a barrier to having children. However, a woman’s fertility decreases as she gets older and its more difficult to have children when your in your mid 40’s. Having diabetes can also at times be an obstacle in getting pregnant.
The best thing would be to talk to an obstetrician. They’ll be able to advice you about your options.
Hullo, am 45 years old. I have a son of 17years,am HIV+ and on ARVs since 2006, am also diabetic and on anti diabetic drugs. Am married and my husband wants a kid. Will it be possible for me to concieve?
Best resource for risk of rare events is to check the Summary of Product Characteristics (SPC) or Product Information.
The i-Base page for all drugs includes a link to this access at the bottom of the age – ie for maraviroc the page is here:
http://i-base.info/guides/3565
The link to the EU website for maraviroc is listed under the brand name Celsentri:
http://www.ema.europa.eu/ema/index.jsp?curl=pages/medicines/human/medicines/000811/human_med_000689.jsp&murl=menus/medicines/medicines.jsp&mid=WC0b01ac058001d124
The SPC/Product Information link is:
http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000811/WC500022190.pdf
Diabetes isn’t listed :)
Hi Simon, do you know if maroviroc is noted for increased risk of diabetes – I have just been pronounced as borderline – thanks
Hi Jacob – thanks – it is important that your diabetes is managed very closely with your HIV, so a doctor who specialise in both conditions is important. Try the Diabetes UK website for information on how to manage diabetes and changes in glucose results. It often takes a while to get levels to be lower and more stable and even then they can still fluctuate.
https://www.diabetes.org.uk/Guide-to-diabetes