title: Oral Glucose Tolerance Testing identifies HIV+ infected women with Diabetes Mellitus (DM) not captured by standard DM definition.
abstract: OBJECTIVE
  HIV-infected (HIV+) individuals may have differential risk of diabetes mellitus (DM) compared to the general population, and the optimal diagnostic algorithm for DM in HIV+ persons remains unclear. We aimed to assess the utility of oral glucose tolerance testing (OGTT) for DM diagnosis in a cohort of women with or at risk for HIV infection.
  
  
  METHODS
  Using American Diabetic Association DM definitions, DM prevalence and incidence were assessed among women enrolled in the Women's Interagency HIV Study. DM was defined by 2-hour OGTT ≥ 200 mg/dL (DM_OGTT) or a clinical definition (DM_C) that included any of the following: (i) anti-diabetic medication use or self-reported DM confirmed by either fasting glucose (FG) ≥126 mg/dL or HbA1c ≥ 6.5%, (ii) FG ≥ 126 mg/dL confirmed by a second FG ≥ 126 mg/dL or HbA1c 6.5%, or (iii) HbA1c 6.5% confirmed by FG ≥ 126 mg/dL cohort.
  
  
  RESULTS
  Overall, 390 women (285 HIV+, median age 43 years; 105 HIV-, median age 37 years) were enrolled between 2003-2006. Over half of all women were African American. Using DM_C, DM prevalence rates were 5.6% and 2.8% among HIV+ and HIV- women, respectively. Among HIV+ women, adding DM_OGTT to DM_C increased DM prevalence from 5.6% to 7.4%, a 31% increase in the number of diabetes cases diagnosed (p=0.02). In HIV- women, no additional cases were diagnosed by DM-OGTT.
  
  
  CONCLUSIONS
  In HIV+ women, OGTT identified DM cases that were not identified by a standardized clinical definition. Further investigation is needed to determine whether OGTT should be considered as an adjunctive tool for DM diagnosis in the setting of HIV infection.
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA.
authors.forename: Sophie
authors.initials: S
authors.lastname: Seang
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA.
authors.forename: Jordan E
authors.initials: JE
authors.lastname: Lake
authors.affiliation: Anthem, Inc., Alexandra, VA, USA.
authors.forename: Fang
authors.initials: F
authors.lastname: Tian
authors.affiliation: Department of Medicine and Epidemiology and Population Health, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Anastos
authors.affiliation: Departments of Medicine, Cook County Health & Hospital System, and Rush University, Chicago, Illinois, USA.
authors.forename: Mardge H
authors.initials: MH
authors.lastname: Cohen
authors.affiliation: Department of Medicine, Division of Infectious Diseases, University of California, Los Angeles, California, USA.
authors.forename: Phyllis C
authors.initials: PC
authors.lastname: Tien
keywords: Diabetes mellitus; HIV; Oral glucose tolerance test; Women