Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study

Abstract Background Few studies have reported hyperglycemia and diabetic ketoacidosis in patients on dolutegravir (DTG) treatment. This study determined the effect of DTG on fasting blood glucose levels in a cohort of persons living with HIV (PLHIV) in Ghana and initiating DTG regimens. Methods A tw...

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Main Authors: Margaret Lartey, Ernest Kenu, Vincent Ganu, Stephen Ayisi Addo, Kofi Agyabeng, Delia Bandoh, Marijanatu Abdulai, Prince Tsekpetse, Kwasi Torpey
Format: Article
Language:English
Published: BMC 2024-11-01
Series:Journal of Health, Population and Nutrition
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Online Access:https://doi.org/10.1186/s41043-024-00695-0
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author Margaret Lartey
Ernest Kenu
Vincent Ganu
Stephen Ayisi Addo
Kofi Agyabeng
Delia Bandoh
Marijanatu Abdulai
Prince Tsekpetse
Kwasi Torpey
author_facet Margaret Lartey
Ernest Kenu
Vincent Ganu
Stephen Ayisi Addo
Kofi Agyabeng
Delia Bandoh
Marijanatu Abdulai
Prince Tsekpetse
Kwasi Torpey
author_sort Margaret Lartey
collection DOAJ
description Abstract Background Few studies have reported hyperglycemia and diabetic ketoacidosis in patients on dolutegravir (DTG) treatment. This study determined the effect of DTG on fasting blood glucose levels in a cohort of persons living with HIV (PLHIV) in Ghana and initiating DTG regimens. Methods A two-year observational longitudinal cohort study conducted from 12th October 2020 to 31st December 2022. Fasting blood glucose was measured at baseline, 12, 24, 36 and 72 weeks for patients after a 12 h overnight fast. The Kaplan-Meier estimator was used to estimate the risk of developing type 2 diabetes mellitus (T2DM). Cox proportional hazard model was used in estimating hazard ratios. Results A total of 1334 non-diabetic patients were enrolled with 78% (1039) females and 83% (1104) were antiretroviral therapy experienced. The incidence proportion and rate of T2DM at 72 weeks were 11.8% (95%CI: 10.2–13.7) and 98.1 cases per 1000 PY (95%CI: 83.9-114.6) respectively. The median time to development of T2DM was 24 weeks post DTG initiation. Male sex (aHR 2.9 [95%CI: 1.9–4.3]), abnormal waist-hip ratio (1.67 [95% CI: 1.15–2.43]) and abnormal total serum cholesterol (aHR 1.6 [95%CI: 1.1–2.3]) were found to be significant determinants of T2DM. Conclusion Incidence of T2DM is high among non-diabetic PLHIV within 72 weeks of initiating DTG based therapy with males having a higher risk. Longitudinal changes in waist-hip ratio and serum cholesterol among patients initiated on DTG needs to be monitored regularly.
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spelling doaj-art-0f94b3ab54ed4cbdb31a43d741b259942025-08-20T02:08:25ZengBMCJournal of Health, Population and Nutrition2072-13152024-11-0143111010.1186/s41043-024-00695-0Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal studyMargaret Lartey0Ernest Kenu1Vincent Ganu2Stephen Ayisi Addo3Kofi Agyabeng4Delia Bandoh5Marijanatu Abdulai6Prince Tsekpetse7Kwasi Torpey8Department of Medicine & Therapeutics, University of Ghana Medical SchoolGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of GhanaDepartment of Medicine, Korle Bu Teaching HospitalNational AIDS/STI Control Programme, Ghana Health ServiceDepartment of Biostatistics, School of Public Health, University of GhanaGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of GhanaNational AIDS/STI Control Programme, Ghana Health ServiceGhana Field Epidemiology and Laboratory Training Programme, Department of Epidemiology and Disease Control, School of Public Health, University of GhanaDepartment of Population, Family, Reproductive Health, School of Public Health, University of GhanaAbstract Background Few studies have reported hyperglycemia and diabetic ketoacidosis in patients on dolutegravir (DTG) treatment. This study determined the effect of DTG on fasting blood glucose levels in a cohort of persons living with HIV (PLHIV) in Ghana and initiating DTG regimens. Methods A two-year observational longitudinal cohort study conducted from 12th October 2020 to 31st December 2022. Fasting blood glucose was measured at baseline, 12, 24, 36 and 72 weeks for patients after a 12 h overnight fast. The Kaplan-Meier estimator was used to estimate the risk of developing type 2 diabetes mellitus (T2DM). Cox proportional hazard model was used in estimating hazard ratios. Results A total of 1334 non-diabetic patients were enrolled with 78% (1039) females and 83% (1104) were antiretroviral therapy experienced. The incidence proportion and rate of T2DM at 72 weeks were 11.8% (95%CI: 10.2–13.7) and 98.1 cases per 1000 PY (95%CI: 83.9-114.6) respectively. The median time to development of T2DM was 24 weeks post DTG initiation. Male sex (aHR 2.9 [95%CI: 1.9–4.3]), abnormal waist-hip ratio (1.67 [95% CI: 1.15–2.43]) and abnormal total serum cholesterol (aHR 1.6 [95%CI: 1.1–2.3]) were found to be significant determinants of T2DM. Conclusion Incidence of T2DM is high among non-diabetic PLHIV within 72 weeks of initiating DTG based therapy with males having a higher risk. Longitudinal changes in waist-hip ratio and serum cholesterol among patients initiated on DTG needs to be monitored regularly.https://doi.org/10.1186/s41043-024-00695-0DolutegravirType 2 diabetes mellitusSub-Saharan AfricaARTCohort studies
spellingShingle Margaret Lartey
Ernest Kenu
Vincent Ganu
Stephen Ayisi Addo
Kofi Agyabeng
Delia Bandoh
Marijanatu Abdulai
Prince Tsekpetse
Kwasi Torpey
Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
Journal of Health, Population and Nutrition
Dolutegravir
Type 2 diabetes mellitus
Sub-Saharan Africa
ART
Cohort studies
title Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
title_full Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
title_fullStr Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
title_full_unstemmed Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
title_short Incidence of type 2 diabetes mellitus in persons living with HIV initiated on dolutegravir-based antiretroviral regimen in Ghana: an observational longitudinal study
title_sort incidence of type 2 diabetes mellitus in persons living with hiv initiated on dolutegravir based antiretroviral regimen in ghana an observational longitudinal study
topic Dolutegravir
Type 2 diabetes mellitus
Sub-Saharan Africa
ART
Cohort studies
url https://doi.org/10.1186/s41043-024-00695-0
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