Diabetes

Can a person develop diabetes after taking Hep C treatment drugs?

[danstewart1958]

I can only say what happened to my family member who never had diabetes.
After or during treatment he developed what they called medically induced diabetes but he was also HIV positive and on meds.....GOD BLESS!!......Dan

[Deb_c430]

I think diabetes is one of the worse, diseases out there,     I am not sure how much HCV has to do with it,  Normally it is genetics, weight and nutrion have a lot to do with it,

There is a Nurse that comes through here name CoWriter, she has a lot of knowledge concerning both Diabetes and HCV. Keep an eye out for her!

[Marcia2202]

Welcome to the forum.

When my hepatologist briefed me about starting treatment one of the things she explained to me was that the most common possible permanent side effects from treatment are diabetes and thyroid problems.

So yes, a person can develop diabetes from Hep C treatment.

Marcia

[mikesimon]

J Hepatol. 2008 Nov;49(5):831-844. Epub 2008 Aug 21.Click here to read Links
    Hepatitis C infection and risk of diabetes: A systematic review and meta-analysis.
    White DL, Ratziu V, El-Serag HB.

    Sections of Gastroenterology and Hepatology and Health Services Research, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA; Houston Center for Quality of Care and Utilization Studies and Section of Gastroenterology, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA.

    BACKGROUND/AIMS: Several studies found hepatitis C (HCV) increases risk of Type II diabetes mellitus (DM). However, others found no or only sub-group specific excess risk. We performed meta-analyses to examine whether HCV infection does increase DM risk in comparison to the general population and in other sub-groups with increased liver disease rates including with hepatitis B (HBV). METHODS: We followed standard guidelines for performance of meta-analyses. Two independent investigators identified eligible studies through structured keyword searches in relevant databases including PubMed. RESULTS: We identified 34 eligible studies. Pooled estimators indicated significant DM risk in HCV-infected cases in comparison to non-infected controls in both retrospective (OR(adjusted)=1.68, 95% CI 1.15-2.20) and prospective studies (HR(adjusted)=1.67, 95% CI 1.28-2.06). Excess risk was also observed in comparison to HBV-infected controls (OR(adjusted)=1.80, 95% CI 1.20-1.40) with suggestive excess observed in HCV+/HIV+ cases in comparison to HIV+ controls (OR(unadjusted)=1.82, 95% CI 1.27-2.38). CONCLUSIONS: Our finding of excess DM risk with HCV infection in comparison to non-infected controls is strengthened by consistency of results from both prospective and retrospective studies. The excess risk observed in comparison to HBV-infected controls suggests a potential direct viral role in promoting DM risk, but this needs to be further examined.

    PMID: 18814931 [PubMed - as supplied by publisher

[jmjm530]

Yes, unfortunately that can happen. As Dr. Dietrich in our "Expert" forum has staged, interferon while ironically sometimes curing some autoimmune disorders (see Mike's study above) can also bring some out of the closet so to speak. Autoimmune diabetes and metabolic syndrome would fall into this category, and a flaring of the metabolic syndome post treatment was specifically mentioned by my treatment doctor. Another autoimmune disorder that has flared with myself (and others) post treatment is the skin condition called rosacea.

-- Jim

[Deb_c430]

thanks Mike!  you ARE THE MAN!, One is the hardest to deal with, I know pregnant woman can get gestational type 2,  

So then Mike would 2 mean nutrition is  and weight can still control it? There is a huge difference between one and two.. So if I am reading this right, HBV is more  the key?

[mikesimon]

The article I posted doesn't address or even mention interferon in association with diabetes mellitus. It addressed the association between HCV and DM specifically and found:
"........Our finding of excess DM risk with HCV infection in comparison to non-infected controls is strengthened by consistency of results from both prospective and retrospective studies. The excess risk observed in comparison to HBV-infected controls suggests a potential direct viral role in promoting DM risk, but this needs to be further examined."

Perhaps the HCV infected patients had taken or were taking interferon but there is nothing in the article which suggests that was the case.

Mike

[mikesimon]

My understanding is that an HBV/diabetes mellitus connection or association was not found whereas an association with HCV and diabetes was found. It's HCV that seems to be the factor according to this article - if I am reading it right.
Mike

[jmjm530]

My reference to the  study you presented was only in respect to the association between HCV and diabetes, not between inteferon and diabetes, therefore my use of the word "irony". Hopefully that was clear, but if not, I'll try and summarize what I said again.

On one hand it appears that HCV increases the risk of diabetes (see study posted by Mike) but on the other hand it appears that the treatment for HCV (interferon) can also increase the risk. The latter statement (treatment for HCV can increase risk) is consistent with interferon's potential to activate autoimmune disorders in some cases. It is also consistent with what both my liver specialist (and Marcia's) said. Also, if you google "diabetes interferon" you will come up with a number of case studies. Larger studies seem sparse but then again, the big pharm money not surprisingly goes to how the tx drugs can help us not to the long term side effects of the drugs, a topic that has been discussed here in length.

[Deb_c430]

ok I am tracking now,   So  does the study go into pre existing  family conditions?

[Deb_c430]

On other thing MIKE, is type one or 2 diabetes?    

[mikesimon]

Why can't you simply admit that you were wrong? We will still think you're smart even if you do make a mistake occasionally.

Here is what you wrote:

"Yes, unfortunately that can happen. As Dr. Dietrich in our "Expert" forum has staged, interferon while ironically sometimes curing some autoimmune disorders (see Mike's study above) can also bring some out of the closet so to speak."

"HCV" doesn't appear in your post Jim. Interferon does and diabetes does and autoimmune does but not HCV. So when you come back and post:

[My reference to the  study you presented was only in respect to the association between HCV and diabetes, not between interferon and diabetes, therefore my use of the word "irony". Hopefully that was clear, but if not, I'll try and summarize what I said again.]
I have to respond that I don't know how it could be clear because you never even mentioned HCV or hepatitis c and that was the point of the article I posted.
I wonder if you just misspoke and that perhaps you were driven by your preoccupation with the dangers of treatment which dovetails nicely with your continual mantra to "watch and wait". Of course the idea that simply having HCV might put someone at increased risk of developing diabetes doesn't support the old W & W but it really is worth knowing about.
Perhaps you might consider filling in the "To" blank and make it clear that you are addressing sieg09 only because initially I thought you were addressing me and/or the article - which you did reference it in your post. Had you put in the name of the person your were addressing and made it clear then I might have understood the irony better.
Maybe not though.
Mike

[mikesimon]

Type 2

[Deb_c430]

that's better Mike,  it is controllable by diet and exercise then,  Thanks again for a clear answer!  

[CoWriter]

"Can a person develop diabetes after taking Hep C treatment drugs? "

Yes.  You can develop diabetes before, during or after treatment.  


BEFORE.....

In cellular metabolism, glucose (sugar) can be converted into fatty acids. Many viruses use these fatty acids to build their viral envelopes, or outer coatings, which help the viruses penetrate and infect human cells.

When the Hepatitis C virus gets into your body, it tries to increase your metabolism so that it can reproduce more quickly by using fatty acids to build protective outer coatings which will help it penetrate and infect your liver cells.

And one of the ways to create more glucose that can be converted into fatty acids, is by making you insulin resistant.... which may advance to diabetes.

It does it to survive.

(***Obviously, besides Hep C, there are other factors associated with developing diabetes, like family history, obesity, long-term steroid use, etc).


DURING.....

During treatment the Interferon alters the balance of your immune system and that may cause SEVERE weight loss very fast.  And that can cause insulin resistance.  Why? Because glucose (sugar) is stored in fat cells. When fat tissue dissapears, it forces the sugar into your blood stream ...which can cause the person to become insulin resistant.  

(***Please notice I said severe, fast, weight loss, NOT gradual weight loss like it's recommended for obesity).

Interferon can cause high blood sugar and diabetes...and it may or may not go away after the treatment is finished.  (There are also some cases of it causing Type 1 diabetes).  

But it can also go the other way and improve existing diabetes.


AFTER

A recent study showed that after an 8 year follow-up, the incidence of glucose abnormalities between long-term SVR's and Non-Responders was not significantly different.

HOWEVER.....glucose abnormalities appeared later in long-term SVR's than on Non-Responders. This difference may be explained by the benefit that clearing the virus has on insulin resistance.  Interestingly, 6 out of 17 cirrhotic Non-Responders developed glucose abnormalities....while only 1 of the 7 cirrhotics with long term SVR developed glucose abnormalities.

Patients who developed Impaired Fasting Glucose and Diabetes had more diabetes risk factors at baseline (family history of diabetes, older age, higher BMI, abnormal HOMA Insulin Resistance values, liver fibrosis and steatosis) which probably played a crucial role in inducing glucose abnormalities despite viral eradication.

Bottom line.....achieving SVR may lower the risk of glucose abnormalities but having a family history of diabetes plays a crucial role in determining which patients are at higher risk of developing diabetes. On Hep C patients with long-term SVR, the possibility of developing diabetes is better predicted by the diabetes risk factors they have at baseline rather than by virus eradication.

Co


http://www.ncbi.nlm.nih.gov/pubmed/1870 ... d_RVDocSum

[Trinity4]

Hubby is 6'1" weights approx 160.  Type 2 diabetes and has never had a weight problem.
No sugar -  lots of protein and fresh veggies.  Limits carbs and fats.  He's on Glipizide/Metformin 5/500 -  2 am -  2 pm.  No amount of diet or exercise will control it.  Pancreas is just worn out.

[CoWriter]

Looks like once more, you and I are in agreement.  

Co

[CoWriter]

"that's better Mike,  it is controllable by diet and exercise then"

Unfortunately, that's not the case.  Some people with Diabetes Type 2  need oral medications and others need insulin.


(Type 2 diabetes means they don't produce enough insulin.
Type 1 means they don't produce ANY insulin.)

Co

[CoWriter]

I meant to say....
"Unfortunately, that's not always the case.  Some people with Diabetes Type 2  need oral medications and others need insulin."

[Deb_c430]

ok, thanks so much Co!   My brother in law has 1, my daughter in law and sister 2, one was gestational, but she is a prime  canidate, DIL