Response to Screening of diabetes mellitus among people living with HIV – a comment on “Diabetes mellitus burden among people living with HIV from the Asia‐Pacific region” (Han et al. 2019)

• Published in: Journal of the International AIDS Society 2019-06, Vol.22 (6), p.e25334-n/a
• Main Authors: Han, Win M, Jiamsakul, Awachana, Kiertiburanakul, Sasisopin, Ross, Jeremy, Avihingsanon, Anchalee
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; AIDS/HIV; Asia; Asia‐Pacific; Blood glucose; Diabetes; Diabetes Mellitus; Glucose; Glucose tolerance test; Glycosylated hemoglobin; Health screening; HIV; HIV Infections; HIV patients; Human immunodeficiency virus; Humans; Letter to the Editor; Letters to the Editor; Mass Screening; screening; Studies; viral suppression
• ISSN: 1758-2652; 1758-2652
• DOI: 10.1002/jia2.25334

The letter notes that the sensitivity of the screening tests used in our study differed substantially, and the author of the letter favoured haemoglobin A1c (HbA1c) and the two‐hour plasma glucose level after an oral glucose tolerance test (OGTT) over fasting blood glucose (FBG). The differences in the number of participants diagnosed by FBG compared to HbA1c and OGTT may reflect the later inclusion of HbA1c and OGTT into our cohort data collection as well as differential costs associated with those tests in the context of routine care. More studies are recommending the use of FBG testing as the primary screening tool to diagnose DM among PLHIV due to the potential risk of HbA1c underestimating glycaemia in some PLHIV (e.g. on certain ART regimens, who have a higher mean corpuscular volume of red blood cells and lower CD4 counts) .