» Articles » PMID: 39377112

A Cascade of Care for Diabetes in People Living with HIV in a Tertiary Care Center in Mexico City

Abstract

Background: Diabetes affects 4.5% of people living with HIV in Mexico. This study aims to describe the diabetes cascade of care (DMC) in people with HIV in a tertiary center in Mexico City.

Methods: We conducted a single-center review of people with HIV aged over 18, using medical records of active people enrolled at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ) HIV Clinic (HIVC). Our analysis focused on their last visit to describe the DMC, aiming to identify gaps in control goals. We included people who had a consultation within the 12 months preceding May 2020.

Results: Out of the 2072 active people, medical records were available for 2050 (98.9%). Among these, 326 people (15.9%) had fasting glucose (FG) abnormalities, of which 133 (40.7%) had diabetes. The prevalence of diabetes among people with HIV was of 6.4% (133/2050). Regarding the DMC, the following proportions of people achieved control goals: 133/133 (100%) received medical care in the last 12 months, 123/123 (100%) had blood pressure (BP) <140/90 mmHg, 73/132 (55.3%) had LDL cholesterol (c-LDL) <100 mg/dl, 63/132 (47.7%) had FG <130 mg/dl, 50/116 (43.1%) had glycosylated hemoglobin (HbA1c) <7%. ABC goals (HbA1c <7%, c-LDL <100 mg/dl, BP <140/90 mmHg) were met in 28/109 (25.6%) people. 126/133 (94%) people with HIV achieved HIV-viral load <50 copies/mL.

Conclusions: Despite the high rate of viral suppression among people with HIV and diabetes, significant challenges remain in achieving comprehensive diabetes control. These findings highlight the need for targeted interventions to improve metabolic outcomes and the overall management of diabetes in people with HIV.

References
1.
Ardern C, Katzmarzyk P, Janssen I, Church T, Blair S . Revised Adult Treatment Panel III guidelines and cardiovascular disease mortality in men attending a preventive medical clinic. Circulation. 2005; 112(10):1478-85. DOI: 10.1161/CIRCULATIONAHA.105.548198. View

2.
Wade A, Maposa I, Agongo G, Asiki G, Boua P, Choma S . Diabetes care cascade and associated factors in 10 700 middle-aged adults in four sub-Saharan African countries: a cross-sectional study. BMJ Open. 2023; 13(4):e069193. PMC: 10151877. DOI: 10.1136/bmjopen-2022-069193. View

3.
Meng Li C, Jie Ying F, Raj D, Pui Li W, Kukreja A, Omar S . A retrospective analysis of the care cascades for non-communicable disease and mental health among people living with HIV at a tertiary-care centre in Malaysia: opportunities to identify gaps and optimize care. J Int AIDS Soc. 2020; 23(11):e25638. PMC: 7673263. DOI: 10.1002/jia2.25638. View

4.
Unger T, Borghi C, Charchar F, Khan N, Poulter N, Prabhakaran D . 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020; 75(6):1334-1357. DOI: 10.1161/HYPERTENSIONAHA.120.15026. View

5.
ElSayed N, Aleppo G, Aroda V, Bannuru R, Brown F, Bruemmer D . 2. Classification and Diagnosis of Diabetes: Standards of Care in Diabetes-2023. Diabetes Care. 2022; 46(Suppl 1):S19-S40. PMC: 9810477. DOI: 10.2337/dc23-S002. View