Why adults living with HIV are at high risk for diabetes

A recent study sheds light on why individuals living with HIV are at a higher risk of developing type 2 diabetes, even when their HIV infection is effectively controlled with modern medications. Researchers from UC San Francisco compared blood samples and fat biopsies from 46 people with well-managed HIV to those of 74 people without HIV. None of the participants in the study were obese or had diabetes at the time of the study.

The researchers discovered that people living with HIV exhibited more fibrosis, or scarring, in their fat tissue compared to those without HIV. This fibrosis was present regardless of the participants' body weight or the specific HIV medications they were taking. Insulin resistance, a key factor leading to type 2 diabetes, was also linked to this fat fibrosis in those with HIV.

Moreover, the study identified a potential blood marker called endotrophin, which could help identify individuals at the highest risk of developing diabetes in the future. The findings emphasize that diabetes risk in people with HIV may not always be evident from body weight alone, as the molecular changes in fat tissue associated with fibrosis differ from those seen in obesity-related fibrosis.

Study author Suneil Koliwad, MD, Ph.D., emphasized that these findings bring us closer to preventing the unique metabolic health issues faced by this growing population. Further research is needed to determine whether fat scarring directly leads to insulin resistance or diabetes in people with HIV. Nonetheless, the study provides a promising step forward in understanding and eventually treating diabetes in the context of HIV.