Metabolic control and determinants among HIV- infected Type 2 diabetes mellitus patients attending a tertiary clinic in Botswana

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Rwegerera, Godfrey Mutashambara and Shailemo, Dorothea H P and Rivera, Yordanka Pina and Mokgosi, Kathryn O and Bale, Portia and Oyewo, Taibat Aderonke and Luis, Bruno Diaz and Habte, Dereje and Godman, Brian (2021) Metabolic control and determinants among HIV- infected Type 2 diabetes mellitus patients attending a tertiary clinic in Botswana. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 2021 (14). pp. 85-97. ISSN 1178-7007 (https://doi.org/10.2147/DMSO.S285720)

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Abstract

Purpose: We primarily aimed at determining the prevalence of metabolic syndrome and abnormal individual metabolic control variables in HIV-infected participants as compared to HIV-uninfected participants given current concerns. Our secondary objective was to determine the predictors of metabolic syndrome and individual metabolic control variables among the study participants to guide future management. Patients and methods: A descriptive, case-matched cross sectional study for four months from 15th June 2019 to 15th October 2019 at Block 6 Diabetes Reference clinic in Gaborone, Botswana. We compared the proportions of metabolic syndrome and individual metabolic control variables based on gender and HIV status by means of bivariate analysis (Chi-squared test or Fisher’s exact test) to determine factors associated with metabolic control. A p-value of less than 0.05 was considered statistically significant. Results: Overall, 86% of the study participants were found to have metabolic syndrome by International Diabetes Federation (IDF) criteria with 79.8% among HIV-infected and 89.1% among HIV-negative participants (p-value = 0.018). Older age was significantly associated with metabolic syndrome (p-value = 0.008). Female gender was significantly associated with metabolic syndrome as compared to male gender (P-value < 0.001), and with a statistically significant higher proportion of low HDL-C compared to males (P-value < 0.001). Female participants were significantly more likely to be obese as compared to males (P-value < 0.001). High trigerylcerides were more common in HIV-infected compared to HIV-negative participants (P-value = 0.004). HIV-negative participants were more likely to be obese as compared to HIV-infected participants (P-value = 0.003). Conclusion: Metabolic syndrome is an appreciable problem in this tertiary clinic in Botswana for both HIV-infected and HIV-negative participants. Future prospective studies are warranted in our setting and similar sub-Saharan settings to enhance understanding of the role played by HAART in causing the metabolic syndrome, and the implications for future patient management.

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