Abstract
Aim:
We conducted a mixed methods feasibility study of the effectiveness and acceptability of an individualised diet and physical activity intervention designed to reduce the risk of type 2 diabetes experienced by people living with HIV.
Methods:
Participants with impaired fasting glucose and HIV were invited to take part in a 6-month diet and physical activity intervention. Individualised advice to achieve 10 lifestyle goals was delivered monthly. Diabetes risk was assessed pre- and post-intervention by measurement of the glucose and insulin response to a 3-hour meal tolerance test. Six-month change was analysed using paired t-tests. Research interviews exploring the acceptability of the intervention and factors influencing behaviour change were conducted with those who participated in the intervention, and those who declined participation.
Results:
The intervention (n=28) significantly reduced glucose and insulin, both fasting and postprandial incremental area under the curve (glucose: 7.9% and 17.6%; insulin: 22.7% and 31.4%, respectively); weight (4.6%); waist circumference (6.2%); systolic blood pressure (7.4%); and triglycerides (36.7%). Interview data demonstrated the acceptability of the intervention. However, participants expressed concern that deliberate weight loss might lead to disclosure of HIV status or association with AIDS-related illness. The belief that antiretrovirals drove diabetes risk was associated with declining study participation or achieving fewer goals.
Conclusions:
We have demonstrated the beneficial effects of a lifestyle intervention in mitigating the increased risk of type 2 diabetes associated with HIV. Future interventions should be designed to further reduce the unique barriers that prevent successful outcomes in this cohort.
We conducted a mixed methods feasibility study of the effectiveness and acceptability of an individualised diet and physical activity intervention designed to reduce the risk of type 2 diabetes experienced by people living with HIV.
Methods:
Participants with impaired fasting glucose and HIV were invited to take part in a 6-month diet and physical activity intervention. Individualised advice to achieve 10 lifestyle goals was delivered monthly. Diabetes risk was assessed pre- and post-intervention by measurement of the glucose and insulin response to a 3-hour meal tolerance test. Six-month change was analysed using paired t-tests. Research interviews exploring the acceptability of the intervention and factors influencing behaviour change were conducted with those who participated in the intervention, and those who declined participation.
Results:
The intervention (n=28) significantly reduced glucose and insulin, both fasting and postprandial incremental area under the curve (glucose: 7.9% and 17.6%; insulin: 22.7% and 31.4%, respectively); weight (4.6%); waist circumference (6.2%); systolic blood pressure (7.4%); and triglycerides (36.7%). Interview data demonstrated the acceptability of the intervention. However, participants expressed concern that deliberate weight loss might lead to disclosure of HIV status or association with AIDS-related illness. The belief that antiretrovirals drove diabetes risk was associated with declining study participation or achieving fewer goals.
Conclusions:
We have demonstrated the beneficial effects of a lifestyle intervention in mitigating the increased risk of type 2 diabetes associated with HIV. Future interventions should be designed to further reduce the unique barriers that prevent successful outcomes in this cohort.
| Original language | English |
|---|---|
| Journal | Diabetic Medicine |
| Publication status | Accepted/In press - 16 Jan 2019 |
