Normally blood glucose is distributed to your body’s tissues under the control of insulin. Glucose is then used as ‘fuel’ to meet the energy required by your body. In some cases, this process is disturbed and more insulin is needed for the tissues to take up glucose from the blood. The tissues are said to be ‘resistant’ to insulin, leading to a condition called insulin resistance; which is more common with increased abdominal fat, buffalo hump and in HIV-positive people on treatments.

Insulin resistance can lead to diabetes, a condition where blood glucose becomes quite high.

The incidence of type II, or mature onset, diabetes increases with age. As a result, as people with HIV live longer due to improved treatments, the incidence of type II diabetes amongst people with HIV has significantly risen.

People with HIV are at increased risk of type II diabetes. Factors associated with this risk are:

• being on the protease inhibitor class of drugs for treatment of HIV
• a higher prevalence of some of the risk factors for diabetes amongst people with HIV

Preventing diabetes is important for people with HIV because it leads to increased risk of cardiovascular disease (for which people with HIV are already at increased risk) and in the longer term is associated with the development of a number of diabetes-related conditions.