Management of diabetes mellitus in people living with HIV: A single-center experience.

Diabetes mellitus (DM) is more common in people living with HIV (PLWH) than in HIV-negative patients. Here we aimed to describe the response of PLWH with DM to glucose-lowering therapies in a reference hospital of northern Italy. 200 PLWH and DM were identified from the database of our clinic. Good control of DM was defined as having fasting glucose <130 mg/dl or HbA1c < 53 mmol/mol. The distribution of glucose-lowering therapies in PLWH was compared with that of HIV-negative patients with DM. Mean total fasting glucose and HbA1C were 143 ± 50 mg/dl (51% exceeding the 130 mg/dl cutoff) and 51 ± 16 mmol/mol (30% exceeding the 53 mmol/mol cutoff), respectively. PLWH were less treated with dipeptidyl peptidase-4 inhibitors (1.7% 9.6%, < 0.01) and sulfonylureas (3.3% 13.2%, < 0.01), being conversely more frequently treated with metformin (53.8% 37.7%, < 0.01), glifozins plus metformin (7.1% 2.0%, < 0.05) or insulin plus other glucose-lowering agents (5.5% 0.5%, < 0.01). An underuse of dipeptidyl peptidase-4 inhibitors was found which was, however, counterbalanced by a higher use of combination of drugs (including glifozins). A rational assessment of drug-drug interactions would contribute to a better selection of the best glucose lowering agent for each antiretroviral therapy.