Click here for a complete list of CME opportunities.
There is variability in reports about the presence of an increased frequency of diabetes mellitus (DM) in older persons with HIV. Most suggest an excess than in a comparison group, but the reasons for this increase are unclear. To address this issue, a longitudinal study of adults 50 years or older with HIV was mounted using data from a clinic in Vancouver, Canada. Data from 1065 patients were identified without DM who had a median of 13 years of follow-up. The onset of DM was identified from medical records using standard diagnostic criteria. DM occurred in 703 persons during the follow-up period. The incidence of DM was 1.61/100 person-years of follow-up, which was about 39% higher than in the general population. In subsequent analyses, those developing DM had a longer period of time consuming older antiretroviral therapy (ART), specifically: certain nucleoside reverse transcriptase inhibitors (such as stavudine and zidovudine) and certain protease inhibitors (such as indinivar and nelfinivar). However, in those developing DM there was less exposure to the newer ART such as tenofovir, atazanavir, and darunivir. Although there is a need for replication of these results, it appears that certain older ART could have been a major cause of incident DM. Still, the authors do emphasize the importance of DM detection and management in older adults with HIV. This website provides such information: On the aging home page go to the banner “CME/CE INFO” and click, then scroll down to Chapter 12 to get an excellent summary of DM, HIV and aging.