Hormonal
Integrase Strand Transfer Inhibitor (INSTI) use was associated with a lower risk of progression from prediabetes to diabetes compared to Protease Inhibitor (PI)-based ART in a specific subset of participants, contrasting with some other observational studies.
This paper's finding that INSTIs might have a lower diabetes risk than PIs in a small group is not definitive. Do not change your medication based on this alone. Focus on the proven risk factors: manage your weight, waist circumference, and triglycerides through lifestyle changes, as these have a stronger and more consistent link to diabetes progression.
In these models... INSTI use was associated with lower risk of DM (BMI as a covariate: HR 0.33; 95% CI 0.10, 1.10; p=0.07; waist circumference as a covariate: HR 0.32; 95% CI 0.10, 1.03; p=0.06).
Why this rating
Small subset analysis (n=46), non-significant p-values, and potential confounding by indication limit the strength of the conclusion.
Source
Risk factors for progression from prediabetes to diabetes among older people with HIV
Mary Clare Masters et al. · AIDS · 2024
DOI 10.1097/qad.0000000000003970
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