# Biomarker-Guided Evaluation of Glycated Testing Modalities for Dysglycemia among Persons Living with HIV (BEGET)

> **NIH NIH R21** · UNIVERSITY OF MARYLAND BALTIMORE · 2024 · $175,410

## Abstract

PROJECT SUMMARY
The risk of developing prediabetes and diabetes mellitus is higher among persons living with HIV (PLHIV). It
has been estimated that about 50% of prevalent cases of diabetes mellitus, and an even higher level for
prediabetes, remain undiagnosed particularly in low- and middle-income countries (LMICs). Empirical evidence
suggests that over-reliance on glucose measures may be partly responsible for the poor diagnosis. The World
Health Organization (WHO) and the International Federation of Diabetes (IDF) have included the glycosylated
hemoglobin (HbA1c) test in their recommendations for diagnosis and monitoring of diabetes mellitus. The
HbA1c test is considered highly valuable for early detection of diabetes and is becoming widely adopted in
clinical practice including in LMICs. However, the HbA1c test is currently not recommended for use among
PLHIV due to unreliable results attributable to the lower hemoglobin levels in this population. The major goal of
the proposed study is to identify appropriate HbA1c diagnostic thresholds for strata of hemoglobin levels and
markers of inflammation, insulin resistance and immuno-virologic status. Fructosamine, an alternative glycated
test, which has no hemoglobin limitation, will also be evaluated. This will be accomplished through the
following specific aims: Aim 1: Utilize hemogram and other biomarker stratifications to determine optimal
HbA1c diagnostic thresholds for diabetes mellitus and prediabetes among persons living with and without HIV.
Aim 2: Determine optimal fructosamine diagnostic thresholds for diabetes mellitus and prediabetes among
persons living with and without HIV. Aim 3: Examine the diagnostic accuracy of combining HbA1c with
fructosamine tests for the assessment of dysglycemia and develop an algorithm to guide testing based on
biomarker levels. A multidisciplinary team of researchers has been assembled for this project, comprising
internationally recognized experts in HIV, non-communicable diseases, diabetology/endocrinology, clinical
chemistry, and infectious disease epidemiology from the University of Maryland, Institute of Human Virology
Nigeria (IHVN) and local researchers from affiliate academic and clinical centers. We are employing a cross-
sectional design to recruit 992 PLHIV along with age- and sex-matched 770 persons without HIV at the
University of Abuja Teaching Hospital, a collaborating partner of IHVN. A comprehensive questionnaire with
relevant components of the WHO stepwise approach instrument (STEPS) will be administered. Blood samples
will be collected for HbA1c and fructosamine tests along with oral glucose tolerance test (OGTT) and relevant
biomarkers (hemoglobin, serum proteins, c-reactive protein, insulin, CD4 count, HIV RNA). Results of HbA1c,
fructosamine and OGTT, with the latter as gold standard, will be used to generate receiver operating
characteristic (ROC) curves to determine optimal cut-offs based on biomarker strata. This project will resul...

## Key facts

- **NIH application ID:** 10884340
- **Project number:** 5R21TW012658-02
- **Recipient organization:** UNIVERSITY OF MARYLAND BALTIMORE
- **Principal Investigator:** JIBREEL JUMARE
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $175,410
- **Award type:** 5
- **Project period:** 2023-07-10 → 2026-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10884340

## Citation

> US National Institutes of Health, RePORTER application 10884340, Biomarker-Guided Evaluation of Glycated Testing Modalities for Dysglycemia among Persons Living with HIV (BEGET) (5R21TW012658-02). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10884340. Licensed CC0.

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