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Download gluco d diabetes12/26/2023 ![]() ![]() In the early anti-retroviral therapy (ART) era, nucleoside reverse transcriptase inhibitors (NRTIs) including didanosine, zidovudine, stavudine, or lamivudine were coupled with non-nucleoside reverse transcriptase inhibitors (NNRTIs). ![]() Restricting the use of dolutegravir in Ugandan ART naïve patients perceived to be high risk for diabetes mellitus may be unwarranted. We also demonstrated that longitudinal changes in BG were independent of conventional risk factors of T2DM in the first 48 weeks of therapy. We demonstrated a low incidence of T2DM in Ugandan ART-naïve patients receiving DTG. A high CD4 count and increased waist circumference were associated with 2hBG increase at week 36. There was a significant increase in FBG from baseline to week 48 and significant reduction in 2hBG (2hBG: − 7.26 mg/dl, IQR: − 21.6, 14.4, p = 0.024) at week 36. The incidence of T2DM was 4 cases per 1000 PY (1/243) and pre-DM, 240 cases per 1000 person years (PY) (54/243). Linear regression models were used to determine adjusted differences in FBG and 2hBG from baseline to weeks 48 and 36 respectively. Secondary outcomes included: incidence of pre-Diabetes Mellitus (pre-DM), median change in FBG from baseline to week 48 and 2-h blood glucose (2hBG) from baseline to week 36. The primary outcome was the incidence of T2DM. Two-hour oral glucose tolerance tests (2-h OGTT) were performed at baseline, 12, and 36 weeks fasting blood glucose (FBG) was measured at 24 and 48 weeks. Methodsīetween January and October 2021, 243 PLHIV without T2DM were initiated on DTG based ART for 48 weeks. We sought to determine if the risk of T2DM is indeed heightened in nondiabetic ART naïve Ugandan PLHIV over the first 48 weeks on DTG. Following reports of anti-retroviral therapy (ART) experienced Ugandan people living with HIV (PLHIV) presenting with diabetic ketoacidosis weeks to months following a switch to dolutegravir (DTG), the Uganda Ministry of Health recommended withholding DTG in both ART naïve and experienced PLHIV with diabetes mellitus (T2DM), as well as 3-monthly blood glucose monitoring for patients with T2DM risk factors. ![]()
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