Diagnosing Diabetes Mellitus With Glycated Haemoglobin in Newly Diagnosed HIV-positive Patients in Buffalo City Municipality, South Africa: A Cross-sectional Study
Olufunso O. Sogbanmu1, 2, *, Larry O. Obi2, Daniel T. Goon3, Anthony Okoh1, 2, Benson Iweriebor1, 2, Uchechukwu. U. Nwodo1, 2, Anthony I. Ajayi4, Tennison O. Digban1, 2
1 SAMRC Microbial Water Quality Monitoring Centre, University of Fort Hare, Alice, South Africa
2 Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Alice, South Africa
3 Faculty of Health Sciences, University of Fort Hare, Alice, South Africa
4 Department of Social Sciences, University of Fort Hare, Alice, South Africa
The HbA1c estimates long-term glycaemic control in individuals. However, scanty data exist on the determination of Diabetes Mellitus (DM) in newly diagnosed HIV patients using the HbA1c screening tool in the South African context. Thus, this study examines the prevalence of diabetes mellitus in newly diagnosed HIV-positive patients in Buffalo City Municipality, East London, South Africa.
This was a cross-sectional study of 335 newly HIV-diagnosed patients between August 2016 and July 2017. Demographic (age, gender, residence, employment status and level of education) and behavioural variables (smoking and alcohol use (past 30 days)) were by self-reporting. Information on HbA1c and other clinical variables were obtained from the medical records of the patients. Diabetes mellitus was defined based on the Society for Endocrinology, Metabolism and Diabetes of South Africa (SEMDSA) 2017 guideline of HbA1c of above 6.5%. Weight and height were measured using standard protocols. Logistic regression analyses were applied to determine the predictors of abnormal glycated haemoglobin.
Majority of the participants were female (72%). The prevalence of patients with HbA1c greater than 6.5% was 6%. The multivariate analysis indicates only age (p=0.031) and race (0.019) significantly shows a correlation to increase the risk of development of DM in newly diagnosed HIV positive patients. The binary logistic regression analysis shows that age (above 46 years) (p=0.001; AOR (6.60); CI (2.08-20.9) was directly related to the development of DM.
Consistent with other studies, the exclusive non-fasting HbA1c, which is a marker of glycaemic control, only underestimate glycemia in HIV patients with diabetes in this present study. Notwithstanding, HIV patients who are over 40 years are likely to develop DM. As such, screening older individuals diagnosed with HIV is crucial in offering a timely point of care and interventions.
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