Q and A

Question

How bad is it to have diabetes and HIV together?

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.

35 comments

  1. Ahmed

    I am writing on blehalf of a good friend living with hiv and type 2 diabetes..
    He is 63 years old and lost so much wait. He is taking daibetes and hiv medicines. He feels hopeless and very weak. He cannot exercise and and does not follow proper diet.
    I want to help him but he refuses anx help or advice.

    Question . HOW CAN i convince and help him.

  2. Roy Trevelion

    Hi Anonymous,

    Has your Mom talked to the doctor about her treatment? Because as Rebecca say above, 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.

    Also, 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.

    So it would be great if your Mom could discuss treatment with the doctor and with a dietitian. How is your Mom?

  3. Anonymous

    Hi all my mom have been living with hiv for some years and she recently found out shes diabetic, what are her chances of living a normal healthy life? Is her life in danger

  4. Roy Trevelion

    Hi Kate,

    Have you had a test for blood sugar levels. Urine tests are not used to diagnose diabetes. Diabetes can be treated and managed along with HIV. But it’s a good idea to talk to your doctor about what HIV meds you’re taking and how best to manage diabetes.

  5. Kate

    I really appreciate what’s going on here. Pls I found out that my urine is very sweet and I went to a near by clinic to check.the result came and it was 18.3 which is very high! Am under treatment now but I want to find out if its related to HIV? Well I have seen few family members with diabetics.

  6. Roy Trevelion

    Hi Pantie,
    Unfortunately we are not doctors at i-base. But having kidney trouble along with diabetes and having to take ARVs too, sounds complex. Can you talk to the doctors about their concerns over your creatinine levels? What county do you live in Pantie? There might be support organisations that could help.

  7. Pantie

    I am taking ARVs, clycomin and Glucophage my problem is before I took ARVS Doctor had concerns about my creatinine that it was above normal and this is still a concern after being on treatment for 61 months what must I do going forward it seems my kidneys are in trouble so is my health but up to now nothing seems wrong.

  8. Roy Trevelion

    Hi, Sorry this sounds really tough. Yes, there has been some link to type 2 diabetes and some ARVs. Here’s a link to the guide to increased blood sugar and type 2 diabetes.

  9. Daven

    On Friday last week I was diagnosed with diabetes type 1 (really bad) which was supposedly caused by my ART combination (Kivexa (abacavir and lamivudine) with Raltegravir/Isentress) . I am now totally insulin dependant with two types of insulin (Levemir as background and Humilog as dietary). This sucks. I would be keen to hear from others who have acquired DT1 or 2 possibly resulting from ARV. Many thanks and we will adapt. It’s just more crap to carry.

  10. Lisa Thorley

    Hi JC,

    Which ARVs are you taking, and what medication are you taking for your diabetes?

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