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Diabetes mellitus prevalence is 6.4% among people living with HIV in East AfricaHIV treatment patients in East Africa face higher diabetes risks

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Key Takeaway
Note that 6.4% of people living with HIV in East Africa have DM, with longer ART duration and obesity as key risk factors.

This meta-analysis synthesizes data from cross-sectional, cohort, and case-control studies to determine the prevalence of diabetes mellitus (DM) and associated risk factors among people living with HIV in East Africa. The analysis identified a pooled prevalence of DM of 6.4% (95% CI: 4.3-9.7%), which equates to approximately 1 in every 16 individuals living with HIV.

Several significant associations were identified regarding risk factors for DM. These include higher education (AOR = 8.56, 95% CI: 3.82-19.17), obesity or overweight status (AOR = 6.68, 95% CI: 2.58-17.32), and a positive family history of diabetes (AOR = 7.60, 95% CI: 3.56-16.22). Additionally, longer duration of antiretroviral therapy (AOR = 4.78, 95% CI: 1.22-18.81) and a history of hypertension (AOR = 2.98, 95% CI: 1.69-5.27) were associated with DM. Male sex and elevated triglycerides were not significantly associated with the condition.

The authors note high heterogeneity (I2 = 94.9%) as a limitation of the study. Given these findings, integrating DM screening and preventive strategies into routine HIV care is suggested to mitigate cardio-metabolic complications in this population.

How this fits prior evidence

This meta-analysis addresses a gap by providing specific prevalence data for diabetes mellitus in East African populations living with HIV. It extends the finding that antiretroviral therapy and other factors are associated with increased cardiovascular risk in HIV patients by identifying longer duration of antiretroviral therapy as a specific risk factor for diabetes. The results also align with the unified cardiometabolic disease framework linking T2DM, hypertension, and other conditions via shared pathophysiology.

Living with HIV and managing it with antiretroviral therapy (ART) comes with its own set of health hurdles. New data from East Africa shows that many people on these treatments are also facing the challenges of diabetes. The study found a 6.4% prevalence rate, which means about 1 in every 16 people living with HIV in this region has diabetes.

Several specific factors were linked to a higher risk of developing the condition. These include being overweight or obese, having a family history of diabetes, and having high blood pressure. Interestingly, the data also showed that people who had been on antiretroviral therapy for a longer period of time faced a higher risk of diabetes.

While these findings highlight important risks, it is important to remember that this study shows links rather than direct causes. The research also noted significant differences in how different studies were conducted, which can make it harder to pinpoint exact reasons. Doctors suggest that screening for and preventing diabetes is a vital part of managing HIV care.

What this means for you:
One in 16 people living with HIV in East Africa has diabetes, especially those on long-term medication.

Common questions

How common is diabetes among people living with HIV?

In the study of people living with HIV in East Africa, the prevalence of diabetes was 6.4%. This means that approximately 1 in every 16 people living with HIV in this region has a diagnosis of diabetes.

What factors increase the risk of diabetes for those on HIV medication?

Several factors were linked to higher risk: being overweight or obese, having a family history of diabetes, and having high blood pressure. Additionally, staying on antiretroviral therapy (ART) for a longer period was associated with an increased risk of developing diabetes.

Does the length of time on medication affect health outcomes?

The data showed that a longer duration of antiretroviral therapy (ART) was associated with a higher risk of diabetes. Because this is an association and not a direct cause, you should talk to your doctor about how long-term treatment affects your specific health plan.

Study Details

Study typeMeta analysis
EvidenceLevel 1
Follow-up192.0 mo
PublishedAug 2026
View Original Abstract ↓
BACKGROUND: The introduction of combination antiretroviral therapy (cART) has improved survival among people living with HIV (PLHIV) but increased the risk of non-communicable diseases, including diabetes mellitus (DM). In East Africa, estimates of DM prevalence among PLHIV vary widely, and contributing factors are not well defined. This study aimed to estimate the pooled prevalence of DM and identify associated risk factors among PLHIV in the region. METHODS: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines (PROSPERO: CRD420251129591). Databases including PubMed, Embase, CINAHL, Web of Science, African Journals Online, and Google Scholar were searched for cross-sectional, cohort, and case-control studies reporting DM prevalence or associated factors among PLHIV aged ≥ 16 years in East Africa. Data were extracted independently by two reviewers, and study quality was assessed using the Joanna Briggs Institute checklist. A random-effects model using DerSimonian-Laird method was applied to estimate pooled prevalence. Heterogeneity was assessed with Cochran's Q and I², and publication bias was evaluated via funnel plot, Egger's test, and trim-and-fill analysis. Adjusted odds ratios (AORs) were pooled to identify factors associated with DM. RESULTS: A total of fourteen studies were included. The pooled prevalence of DM was 6.4% (95% CI: 4.3-9.7%; I² = 94.9%). Trim-and-fill analysis did not change the estimate. Significant risk factors included higher education (AOR = 8.56, 95% CI: 3.82-19.17), obesity/overweight (AOR = 6.68, 95% CI: 2.58-17.32), positive family history of diabetes (AOR = 7.60, 95% CI: 3.56-16.22), longer duration of ART (AOR = 4.78, 95% CI: 1.22-18.81), and history of hypertension (AOR = 2.98, 95% CI: 1.69-5.27). Male sex and elevated triglycerides were not significantly associated. CONCLUSION: DM affects one in every 16 PLHIV in East Africa, with modifiable and non-modifiable risk factors identified. Integrating DM screening and preventive strategies into HIV care is critical to reduce cardio-metabolic complications.
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