【新知轉載】HIV and Diabetes

Last Reviewed: October 6, 2017

Key Points

• Diabetes is a disease in which levels of blood glucose (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy. There are two main types of diabetes: type 1 diabetes and type 2 diabetes.
• Use of some HIV medicines may increase blood glucose levels and lead to type 2 diabetes. Other risk factors for type 2 diabetes include a family history of diabetes, being overweight, and lack of physical activity.
• People with HIV should have their blood glucose levels checked before they start taking HIV medicines. People with higher-than-normal glucose levels may need to avoid taking some HIV medicines and use other HIV medicines instead.
• Blood glucose testing is also important after starting HIV medicines. If testing shows high glucose levels, a change in HIV medicines may be necessary.
• Type 2 diabetes can often be controlled with a healthy diet and regular exercise. A healthy diet includes vegetables, fruits, beans, whole grains, and lean meats and is low in processed foods high in sugar and salt. Regular exercise means being active for 30 minutes on most days of the week. Sometimes, in addition to a healthy diet and regular physical activity, some people may need to take medicines to control type 2 diabetes.

What is diabetes?

Diabetes is a disease in which levels of blood glucose (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy.

Diabetes can cause serious health problems, including heart and blood vessel disease, nerve damage, blindness, stroke, and kidney disease. Fortunately, diabetes can be controlled with diet, exercise, and medicines.

How does diabetes develop?

Glucose is carried in the blood to cells throughout the body. A hormone called insulin helps move the glucose into the cells. Once in the cells, glucose is used to make energy. When the body has trouble moving glucose into the cells, glucose builds up in the blood and can lead to diabetes.

There are two main types of diabetes: type 1 diabetes and type 2 diabetes.

In type 1 diabetes, the body’s immune system attacks and destroys the cells that produce insulin. Lack of insulin causes glucose to build up in the blood.

In type 2 diabetes, the body can't produce enough insulin or use it effectively to move glucose into the cells. Type 2 diabetes is more common than type 1 diabetes.

What are the risk factors for type 2 diabetes?

Risk factors for type 2 diabetes include age over 45, a family history of diabetes, being overweight, and lack of physical activity. People whose family background is African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, or Pacific Islander American are at greater risk of type 2 diabetes.

In people with HIV, the risk of type 2 diabetes is greater in people who also have hepatitis C.

The use of some HIV medicines in the nucleoside reverse transcriptase inhibitor (NRTI) and protease inhibitor (PI) drug classes may increase the risk of type 2 diabetes in people with HIV. These HIV medicines seem to make it harder for the body to respond to and use insulin (insulin resistance). Insulin resistance leads to high blood glucose levels, which can result in type 2 diabetes.

What are the symptoms of diabetes?

The symptoms of diabetes can include:

• Unusual thirst
• Frequent urination 
• Extreme hunger
• Unusual weight loss or weight gain 
• Extreme fatigue and irritability
• Frequent infections
• Blurred vision 
• Tingling or numbness in the hands and feet
• Slow healing of cuts or bruises

How is diabetes diagnosed?

A common test used to diagnose diabetes is the fasting plasma glucose (FPG) test. The FPG test measures the amount of glucose in the blood after a person has not eaten for 8 hours.

People with HIV should have their blood glucose levels checked before starting treatment with HIV medicines. People with higher-than-normal glucose levels may need to avoid taking some HIV medicines. 

Blood glucose testing is also important after starting HIV medicines. If testing shows high glucose levels, a change in HIV medicines may be necessary.

Can diabetes be treated?

Type 2 diabetes can often be controlled with a healthy diet and regular exercise. A healthy diet and daily exercise can help a person maintain a healthy weight. If you are overweight, you may be able to prevent or delay type 2 diabetes by losing weight.

A healthy diet includes lots of vegetables, some fruit, beans, whole grains, and lean meats and is low in processed foods high in sugar and salt. Regular exercise means being active for 30 minutes on most days of the week. To learn more, read this webpage on Diabetes Diet, Eating, & Physical Activity from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).  

Sometimes people may also need to take medicines to control type 2 diabetes. (Treatment for type 1 diabetes always includes taking insulin.)

If you have HIV, ask your health care provider about your risk of diabetes. You can also talk to your health care provider about the link between HIV medicines and diabetes. People with HIV who have diabetes may need to avoid taking some HIV medicines and use other HIV medicines instead.

Where can I learn more about diabetes?

• Browse this webpage from MedlinePlus to find diabetes-related information.
• Try these recipes for people with diabetes and their families from the Department of Health and Human Services (HHS).

This fact sheet is based on information from the following sources:

• From HHS: Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents Living with HIV: Adverse Effects of Antiretroviral Agents and Laboratory Testing 
• From the Department of Veterans Affairs: Primary Care of Veterans with HIV: Diabetes
• From the National Institute of Allergy and Infectious Diseases: A Helpful Guide to HIV and Metabolic Complications
• From NIDDK: What is Diabetes? and Diabetes Diet, Eating, & Physical Activity

原文網址：HIV and Diabetes