Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study

© 2018 The Author(s). Background: Since 2005, Thailand has scaled up one of the largest antiretroviral treatment (ART) programs in South East Asia. Although diabetes mellitus (DM) incidence is increasing in low and middle-income countries, its burden and contributing factors in the HIV infected popu...

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Main Authors: Ninutcha Paengsai, Gonzague Jourdain, Romanee Chaiwarith, Apichat Tantraworasin, Chureeratana Bowonwatanuwong, Sorakij Bhakeecheep, Tim Roy Cressey, Jean Yves Mary, Nicolas Salvadori, Natapong Kosachunhanun
Other Authors: National Health Security Office
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Published: 2019
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/46426
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spelling th-mahidol.464262019-08-23T18:49:10Z Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study Ninutcha Paengsai Gonzague Jourdain Romanee Chaiwarith Apichat Tantraworasin Chureeratana Bowonwatanuwong Sorakij Bhakeecheep Tim Roy Cressey Jean Yves Mary Nicolas Salvadori Natapong Kosachunhanun National Health Security Office Institute of research for development, Thailand Harvard School of Public Health University of Liverpool Mahidol University Universite Paris 7- Denis Diderot Chiang Mai University Medicine © 2018 The Author(s). Background: Since 2005, Thailand has scaled up one of the largest antiretroviral treatment (ART) programs in South East Asia. Although diabetes mellitus (DM) incidence is increasing in low and middle-income countries, its burden and contributing factors in the HIV infected population are not well known. Methods: Using the Thai National AIDS Program data over a period of 8-years, we identified patients diagnosed with DM based on the following records: 1) fasting plasma glucose equal to or greater than 126 mg/dl following the 2013 American Diabetes Association criteria or 2) diagnosis codes E11-E14 of the 2010 WHO International Classification of Diseases, or 3) anti-diabetic drugs. Incidence was the number of new cases divided by that of person-years of follow-up (PYFU). Competing risks survival regression, treating death without DM as a competing event, was used to identify factors associated with DM. The risk of death in patients diagnosed with DM was estimated using Cox regression models. Results: Data of 763,666 PYFU from 199,707 patients (54.2% male; median age 36.2 years at registration with the program) were available and 8383 cases were diagnosed with DM, resulting in an incidence rate of 11.0 per 1000 PYFU. New DM diagnosis was more likely in men (adjusted sub-distribution hazard ratio 1.2), older patients (compared to patients 18 to 34 years old: 1.8 for 35 to 44; 3.0 for 45 to 59; 3.8 for ≥60), and if ART was initiated (1.3). In 2014, 1313 (16.6%) of 7905 diabetic patients had DM complications (11.5% microvascular complications and 6.9% macrovascular complications). Patients diagnosed with DM were at higher risk of death compared to the others. Conclusions: DM incidence was higher in this Thailand cohort of HIV infected adults than in the general population. Risk factors were similar to those in the general population, in addition to starting ART. 2019-08-23T11:49:10Z 2019-08-23T11:49:10Z 2018-08-30 Article BMC Public Health. Vol.18, No.1 (2018) 10.1186/s12889-018-5967-7 14712458 2-s2.0-85052730867 https://repository.li.mahidol.ac.th/handle/123456789/46426 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052730867&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Ninutcha Paengsai
Gonzague Jourdain
Romanee Chaiwarith
Apichat Tantraworasin
Chureeratana Bowonwatanuwong
Sorakij Bhakeecheep
Tim Roy Cressey
Jean Yves Mary
Nicolas Salvadori
Natapong Kosachunhanun
Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
description © 2018 The Author(s). Background: Since 2005, Thailand has scaled up one of the largest antiretroviral treatment (ART) programs in South East Asia. Although diabetes mellitus (DM) incidence is increasing in low and middle-income countries, its burden and contributing factors in the HIV infected population are not well known. Methods: Using the Thai National AIDS Program data over a period of 8-years, we identified patients diagnosed with DM based on the following records: 1) fasting plasma glucose equal to or greater than 126 mg/dl following the 2013 American Diabetes Association criteria or 2) diagnosis codes E11-E14 of the 2010 WHO International Classification of Diseases, or 3) anti-diabetic drugs. Incidence was the number of new cases divided by that of person-years of follow-up (PYFU). Competing risks survival regression, treating death without DM as a competing event, was used to identify factors associated with DM. The risk of death in patients diagnosed with DM was estimated using Cox regression models. Results: Data of 763,666 PYFU from 199,707 patients (54.2% male; median age 36.2 years at registration with the program) were available and 8383 cases were diagnosed with DM, resulting in an incidence rate of 11.0 per 1000 PYFU. New DM diagnosis was more likely in men (adjusted sub-distribution hazard ratio 1.2), older patients (compared to patients 18 to 34 years old: 1.8 for 35 to 44; 3.0 for 45 to 59; 3.8 for ≥60), and if ART was initiated (1.3). In 2014, 1313 (16.6%) of 7905 diabetic patients had DM complications (11.5% microvascular complications and 6.9% macrovascular complications). Patients diagnosed with DM were at higher risk of death compared to the others. Conclusions: DM incidence was higher in this Thailand cohort of HIV infected adults than in the general population. Risk factors were similar to those in the general population, in addition to starting ART.
author2 National Health Security Office
author_facet National Health Security Office
Ninutcha Paengsai
Gonzague Jourdain
Romanee Chaiwarith
Apichat Tantraworasin
Chureeratana Bowonwatanuwong
Sorakij Bhakeecheep
Tim Roy Cressey
Jean Yves Mary
Nicolas Salvadori
Natapong Kosachunhanun
format Article
author Ninutcha Paengsai
Gonzague Jourdain
Romanee Chaiwarith
Apichat Tantraworasin
Chureeratana Bowonwatanuwong
Sorakij Bhakeecheep
Tim Roy Cressey
Jean Yves Mary
Nicolas Salvadori
Natapong Kosachunhanun
author_sort Ninutcha Paengsai
title Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
title_short Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
title_full Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
title_fullStr Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
title_full_unstemmed Incidence and clinical outcomes of diabetes mellitus in HIV-infected adults in Thailand: A retrospective cohort study
title_sort incidence and clinical outcomes of diabetes mellitus in hiv-infected adults in thailand: a retrospective cohort study
publishDate 2019
url https://repository.li.mahidol.ac.th/handle/123456789/46426
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