Diabetes, COVID-19 and People with HIV

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In recent weeks, we have discussed the topic of the most common comorbidities for people with HIV. Diabetes is one of these conditions and having diabetes places you at moderate risk of severe illness from COVID-19.

Most diabetes is either classified as type 1 or type 2 – there are also rare genetic diabetic syndromes. Type 1 diabetes is usually diagnosed during childhood. Type 2 diabetes can develop later in life and is commonly related to modifiable lifestyle factors such as diet and exercise.

Diabetes is a condition that affects the way your body regulates the amount of glucose (sugar) in your bloodstream through the production of a hormone called insulin. However, if you have type 2 diabetes, this process doesn’t work well. People with type 2 diabetes may have insulin resistance (the insulin cannot work properly), their pancreas may not produce enough insulin or both. This results in glucose not being able to enter the cells that need it and instead, it builds up in your bloodstream.

This build-up of glucose in your blood makes it sticky and can result in damage to the blood vessels in different parts of the body. If your cells don’t get enough blood, they cannot function properly – over time, this can lead to serious health problems.

For people with HIV, chronic inflammation (ongoing immune response) associated with HIV may also raise the risk of diabetes. HIV treatment and a healthy lifestyle help reduce inflammation but can’t completely eliminate the risk of acquiring diabetes.

For people treated for HIV before 2000 antiretroviral treatments may have increased your risk of diabetes. They include older nucleoside reverse transcriptase inhibitors (zidovudine, stavudine and didanosine) and older protease inhibitors (indinavir and lopinavir). Click here for further information about this.


Symptoms of type 2 diabetes including increased thirst, frequent urination, increased hunger, weight loss, tiredness, blurred vision, slow-healing sores or frequent infections, and areas of darkened skin. Since these are quite non-specific, many people develop type 2 diabetes without noticing it. Some people with type 2 diabetes have no symptoms and are diagnosed on testing.

Like HIV, type 2 diabetes is a manageable condition. People with type 2 diabetes can work with their doctors and other health care workers to create healthy eating and physical activity plan, to help manage the condition themselves and reduce further complications. If needed, medication can be used to manage type 2 diabetes your doctor will let you know if you should begin taking any medication.

Some of the ways you can reduce your risk of developing type 2 diabetes:

  • reducing the amount of foods in your diet that contain a lot of sugar and fat
  • reducing the amount of fatty red meat in your diet
  • exercising for at least 30 minutes a day

In future posts, we will be going into more detail about how people with HIV can stay active and eat healthily. Stay tuned!

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