Diagnostic Tools

People living with HIV should have fasting blood glucose assessed at HIV diagnosis, prior to starting antiretroviral therapy, and every 6–12 months during antiretroviral treatment.1

Table 1. Diagnostic criteria1*

  Fasting plasma glucose mmol/L
(mg/dL)†
Oral glucose tolerance test (OGTT)
2h value mmol/L (mg/dL)‡
HbA1c§
Diabetes ≥7.0 (126) OR → ≥11.1 (200) ≥6.5%
Impaired glucose tolerance (IGT) <7.0 (126) AND → 7.8–11.0 (140–199) Prediabetes
5.7–6.4%
Impaired fasting glucose (IFG) 5.7–6.9 (100–125) <7.8 (140)

* As defined by WHO and International Diabetes Federation (IDF). 

† An abnormal finding should be repeated before confirming the diagnosis. 
‡ Recommended in patients with fasting blood glucose 5.7–6.9 mmol/L (100–125 mg/dL) as it may identify patients with overt diabetes.

‡Do not use HbA1c in presence of hemoglobinopathies, increased erythrocyte turnover and severe liver or kidney dysfunction. Falsely high values are measured under supplementation with iron, vitamin C and E as well as older age (age > 70: HbA1c +0.4 %).

Both IGT and IFG increase CV morbidity and mortality, and increase the risk of developing diabetes by 4–6 fold. These patients should be targeted for lifestyle intervention, and their CV risk factors must be evaluated and treated.

Reproduced with permission from the European AIDS Clinical Society Guidelines Version 6.0.



Download these diagnostic criteria

A complete medical evaluation should be performed at diabetes diagnosis and at follow up visits.2

A type 2 diabetes risk assessment form that was developed for non-HIV-infected patients by the Finnish Diabetes Association can be found here.

  • Although risk factors for the development of diabetes differ between people living with HIV and the general population, this may provide some useful information during the consultation.

References

  1. European AIDS Clinical Society (EACS). Guidelines. Version 6.0. Accessed 3 July 2012. 
  2. American Diabetes Association. Standards of Medical Care in Diabetes 2011. Diabetes Care. 2011;34;Suppl 1: S11–S61.