HIV is a viral infection caused by the human immunodeficiency virus. This virus attacks cells in your immune system and makes you more vulnerable to developing infections and other diseases.

The development of highly active antiretroviral therapy (HAART) has significantly improved the life span of people with HIV. But some health conditions, such as diabetes, are now more common among people with HIV. This is largely due to people with HIV living longer.

HIV and some HAART medications may also raise your risk of developing diabetes or developing it at a younger age. A 2021 study estimates that as many as 15 percent of people with HIV have diabetes.

Diabetes is a disease that causes high blood sugar levels. If left untreated, high blood sugar can damage your blood vessels and organs and lead to severe complications.

Keep reading as we take a deeper look at the connection between HIV and diabetes, including symptoms and treatment options.

Chronic inflammation caused by HIV and HAART medication may increase your risk of developing diabetes. This increased risk occurs in countries of all income levels. A 2021 study found that people with HIV tend to develop diabetes at a younger age than the general population.

Estimates of how common diabetes is among people with HIV vary between studies, based on factors like the age of participants and where they live.

One frequently cited study estimates that people with HIV are four times more likely to have diabetes than the general population.

A Canadian study has a more conservative estimate of 1.39 times higher risk of diabetes among people with HIV over the age of 50, compared with people the same age without HIV.

Another 2021 study found that the risk of diabetes was 2.08 times higher among people with HIV taking integrase strand transfer inhibitors (an HIV drug), compared with the general local population in South Texas.

HIV medication and the risk of diabetes

From 1994 to 2017, the death rate for people with HIV fell nearly 10 times, from 12.1 to 1.6 deaths per 100 person-years, mostly due to the development of HAART. A person-year is the total number of years researchers observe each person in a group. For example, 100 person-years could mean monitoring 50 people for 2 years or 25 people for 4 years.

Research suggests that while HAART improves the overall quality of life of people with HIV, it may increase the risk of diabetes and prediabetes.

Some HIV medications can negatively affect how you metabolize sugar. This could lead to insulin resistance and interfere with your pancreas secreting insulin.

Certain people are at a higher risk of developing diabetes after taking these medications. Risk factors include:

  • having a family history of diabetes
  • weight gain
  • older age
  • hepatitis C
  • lipodystrophy, changes in body fat distribution that affect some people with HIV

Symptoms of diabetes can include:

Most, if not all, of these symptoms can have multiple causes and are not necessarily the result of diabetes. However, if you have several of these symptoms or suspect you may have diabetes, it’s important to see a doctor as soon as possible to receive a proper diagnosis and treatment.

HIV does not have a cure, but you can keep it in check with HAART. HAART is a customized combination of medications used to suppress the virus.

The treatment guidelines for diabetes in people with HIV are similar to the general population. But the response to diabetes medications may be poorer in people with HIV. Some medications used to lower blood sugar levels may interact with HIV medications, so it’s important to communicate regularly with your doctor.

People with HIV should check their blood sugar levels before starting HIV treatment. Some medications used to treat HIV can raise blood sugar levels even higher or cause weight gain, which is a risk factor for the development of diabetes.

It’s also important to check blood sugar levels periodically while taking HIV medication to see if you need to change your medication.

HIV and type 1 diabetes

Type 1 diabetes is an autoimmune condition in which your body attacks cells that produce insulin. Type 2 diabetes occurs when your body doesn’t produce enough insulin or doesn’t respond properly.

HIV is usually associated with the development of type 2 diabetes, which tends to develop later in life. A few case studies outline rare instances of people developing type 1 diabetes after being diagnosed with HIV. No one knows why this happens.

If you have type 1 diabetes, sexually transmitted infections and other serious illnesses can cause blood sugars to rise and make them difficult to manage. If not controlled, this can trigger a potentially life threatening complication called diabetic ketoacidosis. Learn how to protect yourself.

You may be able to protect yourself from developing diabetes by making some lifestyle and dietary changes. Try to:

  • Eat a balanced diet, and limit refined sugar, salt, and fat.
  • Drink water or other calorie-free drinks as your primary beverages to avoid excessive sugar.
  • Exercise regularly. 30 minutes of moderate exercise per day on most days of the week is ideal.
  • Maintain a moderate weight.
  • Check your blood sugar levels regularly while taking HIV medications and before starting treatment.
  • Quit smoking, or avoid starting if you don’t currently smoke.

Having diabetes and HIV may be associated with poorer survival than having HIV alone. However, treatment is available for both conditions.

In a 2019 study, researchers compared the effect of diabetes on the survival rates of 10,043 people living with HIV. The researchers found that the death rate was almost three times higher in people with diabetes and HIV than with HIV alone.

People who only had HIV lived almost 1.5 years longer than people who also had diabetes, and almost 5 years longer than people with HIV, diabetes, and chronic kidney disease.

Seeking diabetes treatment as soon as possible may help slow its progression and prevent complications.

People with HIV seem to be at a higher risk of developing diabetes than the general population. Inflammation caused by the virus and medication side effects play a role.

Monitoring your blood sugar levels at the beginning of HIV treatment and at regular intervals can help you prevent diabetes or catch it early before serious complications start.

Your doctor can test you for diabetes and advise you on how to manage it. You can also call the National Institutes of Health’s HIVinfo line at 800-448-0440 for more information about living with HIV.