Treatment of type II diabetes

NAM Publications HIV & AIDS Information :: Diabetes

In people receiving HAART, regular monitoring of glucose levels should take place, so that steps can be taken to reduce rising glucose levels before diabetes develops. However, type II diabetes may emerge very rapidly after beginning a new drug combination, and it is not unknown for individuals to go from slightly elevated glucose levels to a diabetic state in a matter of weeks.

The first step in normalising glucose levels is to increase exercise levels, so that the heart rate rises above normal levels for at least 20 minutes each day. Brisk walking may be enough to achieve this. Swimming, cycling, jogging, or more structured exercise such as aerobics classes are also good. Control of hypertension and smoking cessation are also factors in managing diabetes.

Central obesity is known to predispose people to the development of type II diabetes, because the fat around the organs is highly insulin resistant.

In a retrospective study of over 200 patients treated at a Cook County public hospital HIV centre, it was clear that HIV infected diabetic patients were as capable of achieving the goals established by the American Diabetes Association (ADA) as were uninfected patients being seen in the general medicine clinic. Investigators noted the difficulty in reducing lipid levels for those on HAART, but ADA goals (i.e. target hemoglobin levels, blood pressure, and lipid levels) could be met through use of a multidisciplinary team approach that included dietitians and podiatrists.1

References
1. Adeyemi O et al. Are we meeting the American Diabetes Association goals for HIV infected patients with diabetes mellitus? Clin Infect Dis 49(5):799802, 2009

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