Abstract
Background
An aging HIV-infected population has growing recognition for its increasing prevalence of type 2 diabetes mellitus (T2DM). Most studies of T2DM prevalence among patients living with HIV involve selected samples and/or small cohorts which limit generalizability. We sought to evaluate the overall prevalence of T2DM among patients living with HIV in the United States as well as within specific demographic subgroups.
Methods
A cross-sectional analysis was performed using a large, multi-institutional database (Explorys), where clinical information across 27 healthcare networks are matched and standardized to create longitudinal records for each unique patient. At present, the database contains 63 million unique lives, representing 18% of the population across all 4 census regions of the United States. Patients with all types of insurance as well as those who are self-pay are represented. The analysis included adult patients with an active status in the database during April 2014- April 2019 who, not missing data on age, gender, race, and body mass index. The Systematized Nomenclature of Medicine—Clinical Terms (SNOMED-CT) of “Human Immunodeficiency Virus,” “diabetes mellitus type 2,” “disorder due to type 2 diabetes mellitus,” and “Type II diabetes mellitus uncontrolled” were used to identify patients with HIV and T2DM.
Results
We identified 90,900 patients with HIV. The overall prevalence of T2DM among patients with HIV was 22.1% (20,080/90,900) compared with 14.9% (2,679,490/17,946,580) in the general population. In subgroup analysis, the prevalence of T2DM was highest among patients with HIV who were female, older, other race, obese, hypertensive, hyperlipidemic, smokers, alcoholics, and those with a history of hepatitis C infection. Patients with no exposure to antiretroviral therapy (ART) had higher prevalence of T2DM than those with exposure (24.9% vs. 17.6%).
Conclusion
In this US population-based study, we found 1 in 5 people living with HIV had prevalent T2DM. In addition, we observed that HIV-associated T2DM may not depend on chronic ART exposure. Physicians caring for patients with HIV should be aware of the association and should monitor for signs and symptoms of T2DM.
Disclosures
All authors: No reported disclosures.
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