Diabetes mellitus (DM) is increasingly prevalent in people with HIV, with reported prevalence estimates generally ranging from 5% to 15% across contemporary cohorts. It represents a major contributor to both microvascular and macrovascular disease. People with HIV are at increased risk of insulin resistance and type 2 diabetes due to chronic immune activation, antiretroviral therapy–related metabolic effects, and traditional cardiometabolic risk factors. In this context, DM is associated with accelerated atherosclerosis, earlier onset of microvascular injury, and adverse cardiovascular outcomes.
