Introduction
prediabetes’, impaired fasting glucose, Prediabetes, HIV and prediabetes, prediabetes, type 2 diabetes, type 2 diabetes mellitus, diabetes
PREDIABETES, IMPAIRED GLUCOSE TOLERANCE, PREDIABETES, TYPE 2 DIABETES, TYPE 2 DIABETES MELLITUS, DIABETES
The rapidly rising prevalence of type 2 diabetes mellitus is a global public health threat. In sub-Saharan Africa (SSA), an estimated 5% of adults are living with type 2 diabetes [Evidence on the efficacy of type 2 diabetes prevention strategies from SSA is scarce. People with blood glucose levels that fall just below the diagnostic level for diabetes are considered to have ‘prediabetes’. Prediabetes comprises heterogeneous states of impaired fasting glucose (IFG), impaired glucose tolerance (IGT) or, in high-income settings, elevated HbAIn randomised trials, delays in progression to type 2 diabetes have been demonstrated with pharmacological agents, including acarbose [The prevalence of prediabetes among people with HIV has been reported as being between 18% and 26% in SSA, although these estimates are from small studies [Dolutegravir is a HIV-integrase inhibitor that, since 2019, has been part of the first-line therapy for HIV in Tanzania [No trials have been conducted in SSA to evaluate the efficacy of metformin for the prevention of type 2 diabetes. A recent open-label trial conducted among people with HIV and prediabetes in Thailand suggested that metformin may improve glycaemic control compared with no therapy, but this study was small, with just 37 participants in each trial arm [