What question did this study set out to answer?

To assess blood glucose outcomes in ART-naïve Ugandan individuals with HIV and pre-diabetes initiated on dolutegravir.

January 14, 2026Open Access

P-244. Blood Glucose Outcomes of Anti-retroviral Therapy Naïve Ugandan people with HIV with Pre-diabetes Mellitus Initiated on Dolutegravir for 48 weeks

Puntos clave

To assess blood glucose outcomes in ART-naïve Ugandan individuals with HIV and pre-diabetes initiated on dolutegravir.
Matched cohort study comparing 44 individuals with pre-diabetes and 88 with normal glucose levels.
Primary outcome was change in fasting blood glucose and 2-hour blood glucose at specified weeks.
Participants were monitored at baseline, 12, 24, 36, and 48 weeks.
Fasting blood glucose was consistently higher in the pre-diabetes group at all time points.
Improvement in fasting blood glucose by 6.12 mg/dl and 2-hour blood glucose by 23.0 mg/dl in pre-diabetes group at 48 weeks.
Indicates potential for reduced necessity of intensive glucose monitoring in this population.

Resumen

Abstract Background There have been case reports and series of persons with HIV (PWH) developing accelerated hyperglycemia on starting integrase inhibitors with some countries like Uganda adopting intensified blood glucose monitoring in PWH stratified as being at risk. We sought to determine if PWH with pre-diabetes on starting dolutegravir/ lamivudine and Tenofovir Disoproxil Fumarate had worse blood glucose outcomes compared to those with normal blood glucose at baseline.Table 1:Baseline clinical and demographic characteristics compared between participants with pre-diabetes mellitus and those with normal blood glucose at baselineTable 2:Differences in mean blood glucose at different time points compared between participants with pre-diabetes mellitus and those with normal blood glucose at baseline Methods In this matched cohort study, we compared 44 PWH with pre-DM (pre-DM group) and 88 PWH with normal blood glucose (normal blood glucose group) at baseline. The primary outcome was change in mean fasting blood glucose (FBG) from baseline to week 48 and 2-hour blood glucose (2hBG) from baseline to week 36 compared between the two groups.Table 3:Mean blood glucose from baseline to end of follow up for participants with pre-diabetes mellitus and those with normal blood glucose at baseline Results FBG was higher in the pre-DM group at all time points (Adjusted difference in FBG between the pre-DM group and normal blood glucose group at 12 weeks: 4.9 mg/dl, 95%CI (1.5, 8.3), p= 0.005, 24 weeks: 5.4 mg/dl, 95%CI (2.5, 8.3), p= 0.0001, 36 weeks: 2.2 mg/dl, 95%CI (-0.2, 4.7), p= 0.04 and 48 weeks: 4.0 mg/dl, 95%CI (1.3, 6.7), p= 0.004). Similarly, 2-hBG was higher in the pre-DM group at 12 weeks (Adjusted difference in 2hBG between pre-DM group and normal blood glucose group: 10.9 mg/dl, 95%CI (22, 39.9), p= 0.005) and 36 weeks: 10.7 mg/dl, 95%CI (2.6, 18.7), p= 0.01). (Table 2). Despite the pre-DM group having higher mean blood glucose at all time points, this group as well had improvement in FBG at 48 weeks of follow up (adjusted mean difference in FBG at 48 weeks from baseline:-6.12 mg/dl, 95%CI (-9.08, -3.16), p= 0.0001) and 2hBG at 48 weeks (adjusted mean difference in 2hBG at 48 weeks from baseline (a2hBG: -23.0 mg/dl, 95%CI (-33.4, -12.6), p= 0.0001). Table 3 Conclusion We demonstrated that this cohort of ART naïve PWH with pre-diabetes at enrollment have consistent improvement in both fasting blood glucose and glucose tolerance over 48 weeks on TDF/3TC/DTG just like their counterparts with normal blood glucose at baseline. Preferential intensified blood glucose monitoring of these patients in the first 48 weeks may be unnecessary. Disclosures All Authors: No reported disclosures

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