The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic

BACKGROUND: Diabetes mellitus (DM) is an important cause of mortality and morbidity in the US. There are limited data on DM prevalence among HIV infected patients (HIV+ patients). A recent study found that DM prevalence was higher among HIV+ patients (10.3%) vs. the general US population (8.3%), and...

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Autores principales: Jeong, Young-Gwang, Koshy, Sanjana, Salomon, Nadim, Gomez, Tessa, Kobayshi, Takaaki, Kinugawa, Yumiko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632009/
http://dx.doi.org/10.1093/ofid/ofx163.436
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author Jeong, Young-Gwang
Koshy, Sanjana
Salomon, Nadim
Gomez, Tessa
Kobayshi, Takaaki
Kinugawa, Yumiko
author_facet Jeong, Young-Gwang
Koshy, Sanjana
Salomon, Nadim
Gomez, Tessa
Kobayshi, Takaaki
Kinugawa, Yumiko
author_sort Jeong, Young-Gwang
collection PubMed
description BACKGROUND: Diabetes mellitus (DM) is an important cause of mortality and morbidity in the US. There are limited data on DM prevalence among HIV infected patients (HIV+ patients). A recent study found that DM prevalence was higher among HIV+ patients (10.3%) vs. the general US population (8.3%), and was higher regardless of age, sex, and obesity status. We report on the prevalence of pre-DM/DM in our HIV clinic and outcomes. METHODS: Cross-sectional study by retrospective medical record review of patients ≥ 18 years who received HIV primary care at the Peter Krueger Clinic (PKC) at Mount Sinai Beth Israel, NY during October 2015–September 2016. The endocrine clinic is located outside PKC. Data collected include prevalence of pre-DM (Hgb A1C 5.7–6.4) and DM, demographics and HIV disease characteristics. Inadequate glycemic control was defined as Hgb A1C ≥ 7.0 in ≥ 50% of measures during study. RESULTS: There were 1137 HIV+ patients during the study period. The population was mostly Black or Hispanic; mean age was 52.6 ± 11.2 years; 70% were male. Pre-DM prevalence was 301/1137 (26.5%) and DM prevalence was 176/1137 (15.5%). In univariate analysis, patients with DM were more likely to be older, female, Hispanic, HCV co-infected, had higher BMI, longer duration of HIV infection, and family history of DM (all p values < 0.05). Almost 40% of those with DM were also HCV co-infected. Of the 176 with DM, 91 (52%) had inadequate glycemic control. Only insulin use and referral to endocrinology were associated with poor control (P <0.05). CONCLUSION: Rates of DM in our HIV clinic were almost twice the rate reported in the adult US population (8.3%) and 25% had pre DM. Traditional risk factors such as older age, family history, and higher BMI were more frequent in our population. The poorer outcomes in those referred to endocrine probably reflect difficult to manage advanced DM that prompted endocrine referral. The high rates of DM and pre DM supports the DHHS recommendation for screening and consideration of co-location of endocrine services to promote appropriate glycemic control DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-56320092017-11-07 The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic Jeong, Young-Gwang Koshy, Sanjana Salomon, Nadim Gomez, Tessa Kobayshi, Takaaki Kinugawa, Yumiko Open Forum Infect Dis Abstracts BACKGROUND: Diabetes mellitus (DM) is an important cause of mortality and morbidity in the US. There are limited data on DM prevalence among HIV infected patients (HIV+ patients). A recent study found that DM prevalence was higher among HIV+ patients (10.3%) vs. the general US population (8.3%), and was higher regardless of age, sex, and obesity status. We report on the prevalence of pre-DM/DM in our HIV clinic and outcomes. METHODS: Cross-sectional study by retrospective medical record review of patients ≥ 18 years who received HIV primary care at the Peter Krueger Clinic (PKC) at Mount Sinai Beth Israel, NY during October 2015–September 2016. The endocrine clinic is located outside PKC. Data collected include prevalence of pre-DM (Hgb A1C 5.7–6.4) and DM, demographics and HIV disease characteristics. Inadequate glycemic control was defined as Hgb A1C ≥ 7.0 in ≥ 50% of measures during study. RESULTS: There were 1137 HIV+ patients during the study period. The population was mostly Black or Hispanic; mean age was 52.6 ± 11.2 years; 70% were male. Pre-DM prevalence was 301/1137 (26.5%) and DM prevalence was 176/1137 (15.5%). In univariate analysis, patients with DM were more likely to be older, female, Hispanic, HCV co-infected, had higher BMI, longer duration of HIV infection, and family history of DM (all p values < 0.05). Almost 40% of those with DM were also HCV co-infected. Of the 176 with DM, 91 (52%) had inadequate glycemic control. Only insulin use and referral to endocrinology were associated with poor control (P <0.05). CONCLUSION: Rates of DM in our HIV clinic were almost twice the rate reported in the adult US population (8.3%) and 25% had pre DM. Traditional risk factors such as older age, family history, and higher BMI were more frequent in our population. The poorer outcomes in those referred to endocrine probably reflect difficult to manage advanced DM that prompted endocrine referral. The high rates of DM and pre DM supports the DHHS recommendation for screening and consideration of co-location of endocrine services to promote appropriate glycemic control DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2017-10-04 /pmc/articles/PMC5632009/ http://dx.doi.org/10.1093/ofid/ofx163.436 Text en © The Author 2017. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Jeong, Young-Gwang
Koshy, Sanjana
Salomon, Nadim
Gomez, Tessa
Kobayshi, Takaaki
Kinugawa, Yumiko
The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title_full The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title_fullStr The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title_full_unstemmed The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title_short The Prevalence and Outcome of pre-DM/DM in an Urban HIV Primary Care Clinic
title_sort prevalence and outcome of pre-dm/dm in an urban hiv primary care clinic
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5632009/
http://dx.doi.org/10.1093/ofid/ofx163.436
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