Diabetes and pre-diabetes among HIV-positive persons aged 18 years and above in Kabarole District: Prevalence and associated factors

Abstract

Background: The relationship of HIV-AIDS and NCDs is a complex web that includes; the effect of ART therapy and its associated metabolic disorders, nutritional counselling given to HIV/AIDS patients and the lifestyle exhibited by HIV/AIDS patients (Hagos, 2015) (Ga & Wunamir, 2015). Objective: The study aimed at determining the prevalence of diabetes and pre-diabetes and the factors associated among persons aged 18 years and above living with HIV/AIDS in Kabarole district. Methods: This was a health facility based cross sectional study that was conducted in 16 ART clinics in Kabarole District. A total of 480 participated in the study. Data was collected using the WHO STEPS tool. Results: The prevalence of diabetes among persons aged I8 years and above was 2.5% whereas that of pre- diabetes was 10.2%. Body Mass Index (BMI) was significantly associated with both pre-diabetes and diabetes. Participants whose BMI was >25.0kg/M2 were about 10 times likely to be found with pre-diabetes compared with their counterparts with a BMI ≤24.9kg/M2 (aOR 9.6 95% CI 4.00-23.00). Among participants that were found with diabetes a BMI >25.0kg/M2 increased the likelihood by about 16 fold (aOR 15.5 95%CI (2.58-98.96) compared with those with a BMI ≤24.9kg/M2. Participants that had a high blood pressure were 27 times likely to be diabetic compared to their counterparts with normal blood pressure(aOR 26.81 95%CI 4.43-162.33). Urban residents were about 4 times more likely to have pre-diabetes compared to rural residents (aOR 3.75 95%CI 1.58-8.93). Similarly participants that had ART regimens containing Zidovidin (AZT) were 2 times more likely to be diagnosed with Pre-Diabetes compared to those with Tenefovir (TDF) containing regimens (aOR 2.84 95%CI 1.07-7.57). Conclusion: Body mass index is a strong predictor of diabetes and pre-Diabetes but the association is stronger with diabetes. HIV patients taking AZT containing regimens have about 2 times more the risk of developing abnormal glucose regulation (Pre-Diabetes) compared to those on TDF based regimens.