Diet

Dietary changes recommended for people with diabetes include:

• Increasing fibre by eating more wholegrains, beans, and fresh fruit and vegetables.

• Reducing consumption of saturated fats (i.e. animal fats such as butter, lard, cream).

• Reducing consumption of trans fatty acids (margarine) and hydrogenated fats (found in prepared foods, e.g. cakes, biscuits, pizza).

• Increasing consumption of polyunsaturated fats (oils from corn, sunflower, safflower, and soybeans).

Consultation with a specialist HIV dietitian is recommended before commencing a diet targeting diabetes, to ensure it will not worsen wasting, levels of blood fats, or the absorption of anti-HIV drugs.

The extent to which dietary changes can improve insulin resistance and diabetes in people with HIV has not been established. Case studies suggest that some individuals see an improvement after dietary intervention but some trials have reported disappointing results.

If diet and exercise changes are not enough to normalise glucose levels, and antiretroviral drugs cannot be switched to remove the agent that is causing the glucose elevation, drug therapy for diabetes may be recommended. Patients starting diabetes drugs should continue to exercise and persist with changes to diet, to help to lower blood sugar.