Objective: Better understanding of glucose metabolism in HIV patients after initiating anti-retroviral therapy (ART) is important to target treatment and follow-up for diabetes risk and other non-communicable diseases in resource-limited settings. The aim of this study was to assess the changes and predictors of glucose metabolism and blood pressure among HIV patients on ART for 12 months.

Methods: One-year follow-up of Ethiopian HIV patients after initiation of ART was done. Outcomes were changes in fasting plasma glucose (FPG), and 30-minute (30mPG) and 2-hour plasma glucose (2hPG) after oral glucose tolerance test, glycated hemoglobin (HbA1c), fasting plasma insulin (p-insulin), homeostatic model assessment index for insulin resistance (HOMA-IR) and blood pressure. The mean age was 33 years and the majority were women.

Results: During the first 12 months, levels of all plasma glucose parameters decreased, while p-insulin (10^B 3.1; 95% CI2.4, 4.0), HOMA-IR (10^B 3.1; 95% CI2.3, 4.0), and systolic blood pressure (B 4.0; 95%CI2.5, 5.5) increased. Fat-free mass at baseline predicted higher increments in p-insulin, HOMA-IR and blood pressure, whereas fat mass predicted higher increment in HbA1c.

Conclusions: Among Ethiopian HIV patients, blood pressure and insulin increased and all glucose parameters declined during 12-month of ART. Only longer-term follow-up will tell us whether insulin increase is due to insulin resistance or from recovering β-cells.