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190 Cardio Diabetes Medicine 2017

Diabetes And Systemic Complications in
Immune Deficiency Syndrome

Prof. Kutikuppala Surya Rao
MD., MNAMS., DFM., FHM(CMC Vellore)., PhD., FRCP(London)
Chief Consultant Family Physician & HIV Medicine Specialist, Sri Surya Clinic,Visakhapatnam-08
Honorary Professor, Dept of Human Genetics,A ndhra University, waltair

Introduction: 100 to 300 cell/cumm.
A diverse HIV/AIDS patients are increasingly de- Conclusions: This original study first of its kind in the
veloping Diabetes and its complications; hence the world has a significant discovery of 37% were with
morbidity and mortality due to this metabolic disor- high levels of Hb A1c , a clear indication of high
der have been causing more threat than HIV dis- diabetes among HIV infected,20.5% positive for tTG
ease itself. Therefore an original study was conduct- so that the HIV positives prone to developing celiac
ed for the Comprehensive Autoimmune Diabetes disease. 13.75% patients had elevated levels of TPO
and Complications profile measuring such as Insu- antibodies suggestive of autoimmune inflammation
lin Antibody (IAA), Glutamate decarboxylase (GAD- of the thyroid gland and prone for high risk of devel-
65) antibody. Insulinoma Associates 2 antibodies oping thyroid diseases. It is recommended to have an
(IA-2antibody),Thyroglobulin antibody, Thyroid Per- annual TSH test to monitor for thyroid disease. The
oxidase antibody, (TPO)Tissue Transglutaminase an- C-Peptide is suggestive of insulin production and to
tibody (tTG) ,Total Serum IgA,Estimated average glu- help determine the cause of low blood sugar (Hypo-
cose(eAG),C-Peptide and Hemoglobin A1c levels in a glycemia) and pancreatic autoimmunity. Mandatory
scientifically diagnosed HIV/AIDS cohort of positive autoimmune diabetes and complications profile test-
non diabetic patients. ing amongst HIV/AIDS patients would help to predict
Material: One Hundred (100) non Diabetic HIV Pos- the onset of said diseases much earlier than classical
itive naive patients were enrolled in the study by presentation per.se.
following ethical guidelines for comprehensive Au- Background: Diabetes is not a single disease enti-
toimmune Diabetes and Complication Profile study ty. In 1997, it announced the etiological division of
at Sri Surya Clinic, Visakhapatnam South India. The diabetes, which distinguishes two main forms: type
DiabetOmics, Hillsboro USA, a global medical diag- 1 and type 2. In the pathogenesis of both forms ge-
nostics company extended scientific support of test- netic and environmental factors play the role. Type 2
ing the samples for the research from January 2014 to is the more common form, representing about 90%
March 2016. The analysis of the experimental study of all cases of the disease in the developed regions
was done in an institutional setting. of the world civilization. It is characterized by the
coexistence of insulin deficiency and the peripheral
Observation: In the subject studied 71% Male and 29%
Female. Among Males 42% are 41years and above effects of the hormone . Immunological markers do
, 28% are 21 to 40 years and 1% is below 20 years. not appear, and the genetic basis has no connection
Among women 15% are 41 and above years 14% are with the HLA system. In addition, there is rising inci-
21 to 40 years. The study revealed that 41% positive dence of type 2 diabetes in children and adolescents
for C-Peptide, 37% positive for Hb A1c, 20.5% were . In the end, the last two decades have produced im-
Positive for tTG, 13.75% patients had elevated levels portant findings about monogenic forms of diabetes,
of TPO antibodies. Regarding the viremia 37% had revealing mainly in the developmental age and young
Undetected HIV Viral Load 40% had below 1 Lakhs adults . These findings have proved that diabetes has
copies/ml, 23% had more than 1 Lakhs copies/ml vi- much more diverse etiology, than recently thought.
ral load in plasma while 59% had CD4 counts from In the last few years, it has been shown that auto-

GCDC 2017