Glycemic control and factors associated with suboptimal glycemic control among adults living with HIV and diabetes mellitus attending Infectious Disease Institute Clinic Mulago

Abstract

Background: Worldwide there is an increase in the prevalence of diabetes mellitus II among people living with HIV. HIV infection and its management not only increase the risk of diabetes mellitus II but also make glycemic control among people living with HIV difficult compared to the HIV-negative population.

Objectives: The objective of this study was to determining glycemic control and factors associated with sub-optimal glycemic control among adults living with HIV and diabetes mellitus II attending IDI clinic Mulago.

Methods: A cross-sectional study was conducted at IDI clinic Mulago among 211 participants from march to June 2023. A simple random sampling was used to select participants. The level of glycemic control was assessed using glycated hemoglobin. Data was collected using structured and standard face to face interview, anthropometric measurements and review of records for ART regimen, CD4, viral load suppression and type of diabetic medication. Data was entered into Epi data version 4.1 and exported into STATA version 15.0 for analysis. Poisson regression model was done to identify factors associated with inadequate glycemic control. Results: The overall prevalence of suboptimal glycemic control among participants was 61.1% [95% CI: 54.2-67.8]. The participants who were on insulin as diabetic medication were 7.5 times more likely to develop sub-optimal glycemic control than their counterparts taking oral medication (aPR= 7.5; 95% CI: 1.85, 8.04). Overweight participants were 1.6 time more likely to develop sub-optimal glycemic control compared to the participants with normal weight (APR= 1.6; 95% CI: 1.23, 3.10). Those participants with underweight were 2.3 times likely to develop suboptimal glycemic control compared to the participants with normal weight (APR= 1.5; 95% CI: 1.53, 6.131.). Conclusion: Overall, more than half of people living with HIV and diabetes had sub-optimal glycemic control. Being on insulin and one’s weight were significantly associated with suboptimal glycemic control. clinicians should concentrate on helping individuals living with HIV and diabetes mellitus II maintain appropriate glycemic control by focusing on achieving normal weights and appropriate use of insulin.