The relationship between age and glycaemic control in patients living with diabetes mellitus in the context of HIV infection: a scoping review

Background: Patients living in low- and middle-income countries (LMIC) comprise approximately 79% of the global number of adult patients living with diabetes (PLWD). In addition, South Africa (SA), a LMIC, has the highest prevalence of HIV infection globally (13%). The literature suggests that poor glycaemic control is found in the younger PLWD while older PLWD have a poorer quality of life with greater disability. With the effective roll-out of anti-retroviral treatment (ART), patients are living longer and can develop diabetes mellitus as a result of longevity, ART and the HIV infection itself. Assessing the relationship between age in PLWD and HIV would help in developing effective strategies that can be implemented to optimise healthcare for this cohort of patients. Objectives: A study was undertaken to summarise publications on age and glycaemic control in PLWD within the context of an HIV infection. Methods: A scoping review was performed using online medical journal search engines with specific search terms according to the PRISMA guidelines. The Abstracts of articles were read and articles that matched the search criteria were downloaded and read in full. If they matched the chosen topic, they were summarised for analysis. Results: There were 260 results found across 3 medical search engines (55 from Cochrane; 59 from PubMed; 101 from Scopus). A Google search was conducted for completeness (45 results). Seventeen journal articles were identified for the scoping review with 45 095 patients included in these studies from 7 countries. Associations between age and glycaemia differed greatly, being dispersed among the ‘older age has worse glycaemia category’, ‘non-significant category’ and ‘older age has improved glycaemia category’. Conclusion: Varying data exist on the associations between glycaemic control and age in PLWD in the context of HIV infection. Further studies are recommended to determine associations in this regard, especially in LMIC where HIV and DM have a higher prevalence.