Health alert- ARVs could spark off diabetes

Nov 22, 2009

IMAGINE a situation where you have to spend more than half of your earning on medication so you can live for another day. This is a reality of diabetic patients who are also on antiretroviral treatment (ARVs).

By Patience Aber

IMAGINE a situation where you have to spend more than half of your earning on medication so you can live for another day. This is a reality of diabetic patients who are also on antiretroviral treatment (ARVs).

Josephine Acan is diabetic, hypertensive and HIV-positive. She feels like she is caught between a rock and a hard place. In 2004 she was diagnosed with diabetes, four years after she enrolled for ARV treatment.

Acan says she spends over sh500,000 on medication for diabetes and hypertension. “I take Meforimin and Glibenatamin for diabetes. A full dose for each costs over sh200,000 yet I also have to buy drugs for hypertension.

Each of the two prescribed drugs costs over sh70,000.” She says she is also prone to infections like malaria and flu whose treatment is also costly. Acan is a civil servant, who has no health insurance. She has to foot her bills using her earnings.

“Normally when I get better I skip treatment because this medicine is very expensive. Sometimes my relatives help when I run short of money, but the help comes on rare occassions,” she says.

Acan is one of the hundreds of diabetics living with HIV/AIDS who are finding it difficult to access medication. She says recently a member of the Diabetic Association died after he failed to access medication.

Alice Lamwaka, a doctor at Gulu Hospital, says people who are taking ARVs are prone to developing diabates and hypertension.

Lamwaka says even without ARVs, being infected with HIV can damage the pancreas, leading to diabetes. “Once the pancreas is attacked and its cells are destroyed, one easily gets diabetes.

The pancreas secretes insulin, which is of fundamental importance in the handling of glucose. If the pancreas is not functioning properly, diabetes may develop” says Lamwaka.

Lamwaka also says other diseases like tuberculosis and cancer can affect the pancreas. “With the increasing rate of HIV/AIDS infections and the rise in the number of people taking ART, more people are going to get diabetes.

An upward trend has been observed in the number of patients diagnosed with diabetes.” She says there is an increase in the number of referrals from other health units.

“We began the diabetic clinic with only 20 diabetic patients and 70 hypertensive patients in 1998 but now there are over 2000 diabetic patients and over 15,000 patients living with hypertension,’’ she says.

The UN news agency, the Integrated Regional Information Networks (IRIN), reported that as more and more HIV-positive people receive ARVs, their risk of contracting non-AIDS related illnesses, such as diabetes and heart disease, is on the rise.

According to the agency, both HIV infection and the use of ARVs contribute to a greater incidence of metabolic abnormalities known to be risk factors for cardiovascular events.

This raises concerns that the increased prevalence of metabolic abnormalities currently observed in the HIV-1-infected
population may not only increase the risk for future vascular complications but may cause the development of
neurocognitive abnormalities.

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