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What is the influence of HIV serostatus on HbA1c? A prospective analysis using continuous glucose monitoring.

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posted on 2024-05-28, 17:23 authored by Harriet E. Daultrey, Nick S. Oliver, Juliet E. Wright, Tom J. Levett, Ali J Chakera

Objective Type 2 diabetes is reported to be more common in people living with HIV(PLWH). Clinical guidelines recommend screening for diabetes in PLWH but there is no agreed method due to studies reporting HbA1c is falsely low in PLWH. These studies were performed in the early HIV era when participants were taking older preparations of ART that are rarely used today. We aimed to investigate if HIV serostatus influences HbA1c.

Research Designs and Methods We conducted a prospective cohort study of PLWH and age-and sex-matched HIV-negative participants who were purposely recruited from clinics in Brighton, UK. Each participant wore a Dexcom G6 CGM for up to 10 days, had glucose measured during an OGTT, Fructosamine and paired HbA1c measured. We performed regression analysis to assess the influence of HIV on HbA1c and used a separate model for CGM glucose, venous glucose and Fructosamine. In addition, we included predictor variables used in previous studies that explored HbA1c discrepancy.

Results We recruited 60 PLWH (90% male, 50% with T2DM, mean age[±SD] 57[±10.7] years, 100% undetectable viral load) and 48 people without HIV (92% male, 30% with T2DM, mean age 57.7[±8.9] years). We found that HIV serostatus did not have a significant influence on HbA1c within the regression models.

Conclusion We performed a comprehensive assessment of glycaemia to assess if HIV serostatus influences HbA1c. We did not find any strong evidence that HIV serostatus influenced HbA1c. The results of our study support incorporating HbA1c into routine clinical bloods in PLWH.

Funding

Dexcom provided the sensors, transmitters and receivers for this study.

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