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Does Hep C treatment cause diabetes?
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Does Hep C treatment cause diabetes?

Does anyone know where I can get information about diabetes onset with Hep C treatment?  My husband has been on PEG-Intron for 13 weeks with excellent results.  Two weeks ago I rushed him to the hospital violently ill.  His blood sugar was 500 and he had diabetic ketoacidocis.  Last week the same thing happened only he went into diabetic shock.  He was just released yesterday.  There is absolutely NO diabetes in his family ANYWHERE.  He is 53 and now on 4 shots a day of insulin.  None of the myriad of Dr's he has seen have any idea what is going on.  Their words are; baffled, mystified, cunundrum, etc.  Well SOMEONE, SOMEWHERE must know something!

HELP!!!!!!!!!!!!!!!!!!!!!!
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How come these doctors didn't know that interferon can cause glucose spikes? ( I know of one other person who has presented with diabetes after only 2 or 3 weeks of shots.)  Conversely, insulin resistance (fairly common in HCV patients) can impair rseponse to IFN and riba, so you definitely want to get this one under control.

See <a href=http://www.natap.org/2005/HCV/033005__01.htm>Insulin Resistance Impairs Response to IFN/RBV</a>

And here's a quote from the Projects in Knowledge/Education Initiative in Gastroenterology "Care and Counsel II Side Effects Management Handbook"  (posted on the web):

"Acute treatment with interferon alfa results in an increase in counter-regulatory hormones as well as a hypermetabolic response, leading to insulin resistance.  These effects are dose dependent and decrease over time."
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Avatar_n_tn
here is a site to get started...please keep in mind that the "hepc" is a cause for diabeties...not just the treatment!

http://search.juno.com/search?r=search&source=client&query=HEPATITIS+C+A+DIRECT+CAUSE+OF+DIABETES
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Avatar_n_tn
this is a good one:

http://www.hepcassoc.org/news/article85.html
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Avatar_n_tn
here's cuteus article again...the above link didn't work for me...

http://www.natap.org/2005/HCV/033005_01.htm
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Avatar_n_tn
calif sorry...(not cuteus)

hey though that article is just saying that interferon doesn't work as well with diabeties...i'm wondering if there is a better article to support the idea that the tx actually causes the diabeties...cause i know the hep c does just by itself...
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Avatar_n_tn
It says both things, makes a dual argument:

"Interferon induces insulin resistance . . .  induces a decrease in glucose uptake by peripheral tissue and the liver.  However, this effect disappears when analyzed after 3 months of treatment...."  

"interferons have been reported to impair glucose tolerance"

etc.

The assumption that interferon can have this effect is embedded throughout the article, but you're right, it's not the main thesis.  The information is treated as a "given."   So what's up with the baffled doctors then?
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Avatar_n_tn
sorry i've had way too much coffee today...i just skimmed the article...woops!!!
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Avatar_n_tn
I didn't read a definative answer but specualtions from articles. Is anyone on tx experiencing hyperglycemia? LvdByGod!? Califia? Or anyone else? If so, on a daily basis after your last meal of the day how elevated are you? I'm curious because my transplant meds has made me into a diabetic. If I start tx this could cause a major problem.
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Avatar_n_tn
That is one thing I personally am NOT experiencing.   No symptoms, that is, and no one has ever thought to monitor glucose levels.  I know that a  woman who used to post on this list (Silvermoon) became diabetic almost immediately upon taking interferon.  But in your case wouldn't the challenge be to monitor constantly and adjust insulin accordingly?   I know it's easier said than done (my dad was diabetic), but I don't see why you should be prevented from treating.

Mike Simon, you around?  Maybe you could field this.
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Avatar_n_tn
That's really good news. I've been surfing the net and it appears interferon related diabetes is on a case by case basis, with the majority non diabetic.

As far my insulin shots, I stopped them several months back and am taking half of the minimum dose of Metformin (Glucophage) - half tablet. I'm right at the borderline of being and not being a diabetic. My goal by the end of the year is to be non-diabetic. Besides I hate needles!

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Avatar_n_tn
i had my highest glucose level before starting tx and i was found to be a borderline diabetic but ever since i started treatment i have been in the normal range and i have been on tx for a year and a half now...

if the "hepc" is causing or agravating the diabeties than perhaps the treatment could improve it? just a thought...

you won't know until you try the treatment as to how it affects you and begin to monitor it...this is something that should be watched with your treatment blood tests each month...everyone responds differently to treatment...
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Avatar_n_tn
Thanks for the encouragment. You're right, I won't know until I begin tx and its still months away.
My blood draws are currently monthly. Once I begin tx they will be weekly, then twice monthly, and back to monthly.
FYI,  transplant aggitates the HCV and it becomes more active. I want to start tx now but one step at a time.
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Avatar_n_tn
Well,  I didn't get ton of help here, but thanks anyway.  After another 5 days in the hospital, no one really knows what is going on.  How many times does my husband have to go into ketosis before someone tells us what is going on.  It is so frustrating.  Keep om the tx, and keep getting 500 blood sugars.  I hope my husband survives this nightmare.
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Avatar_n_tn
i developed diabetes with sugars ranging from 300-570 after becoming infected with hepatitis C at 38 years of age. I do have a family history of diabetes but not a strong one. There is enough evidence in the literature to strongly suggest that diabetes can develop after hep C infection alone and also with IFN treatment. The fact that your husband has been repeatedly hospitalized for DKA is a reflection of the care he has been receiving from his primary medical doctors. You may want his diabetes to be managed by a board-certified endocrinologist or diabetic specialist (somebody who is knowledgeable of all the cutting-edge research in diabetes). I am on the medtronic insulin pump which delivers insulin continuously rather than the traditional shots people get. I am certain that better control can be achieved with more intensive insulin therapy. Wish you and your husband the best.  
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Avatar_f_tn
Before tx I was pre-diabetic, which became full fledged diabetes during tx.  Now that I've been off interferon and riba for 6 months, the glucose levels have been much more controllable.  I'm taking 19 units of Lantus insulin nightly and - if I watch what I eat - that seems to handle the situation quite nicely most of the time.  I should probably resume metformin, which my primary care doc told me to stop using when my ALT went up prior to diagnosis with hcv.  i will ask for it on my next appointment with him.

In general, as I understand it, if you develop diabetes or pre-diabetes from tx or from hcv itself, most likely you were in line to get the disease anyway.  Interferon, whether from hcv or from a pharmaceutical company, just brings it on sooner.  But I really don't know the answer to that question.  In my case, I am not overweight, which is usually the main cause of Type 2, but my brother and mother had diabetes and weren't overweight either, so who knows what brought it on?  

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Avatar_f_tn
The interferon kills the pancreus and causes diabetes.  My husband went on interferon and developed Type 1 diabetes.  The doctor did not recognize the symptoms as he became sicker and sicker.  He ended up in the hospital with blood sugar over 600!  He was in a coma for 10 days.  Eight years later he is now a type 1 diabetic with hepatits C.  Read the insert on your interferon packet.  It clearly says it may cause Type 1 diabetes.  If anyone had told us this, our decision would have been different!
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Avatar_f_tn
The interferon kills the pancreus and causes diabetes.  My husband went on interferon and developed Type 1 diabetes.  The doctor did not recognize the symptoms as he became sicker and sicker.  He ended up in the hospital with blood sugar over 600!  He was in a coma for 10 days.  Eight years later he is now a type 1 diabetic with hepatits C.  Read the insert on your interferon packet.  It clearly says it may cause Type 1 diabetes.  If anyone had told us this, our decision would have been different!
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I developed insulin dependant diabetes either from Hep C and cirrhosis or the 3 Tx's I have been on, or both.

I used to have a problem maitaining stability when I was just taking orals but got much better results when I went to full time insulin, although I did spaend a night in the hospital last week after going low (~10) and passing out. Nothing like waking up and being surronded by the FD EMT's! For many a 10 would mean a coma but I can tolerate the highs and lows fairly well. I was taken of glyburide and metformin and put on glipizide also.

The biggest thing that has helped me with both the Hep C and diabetes (besides a good diet) is going to the gym every day and doing a good cardio workout of 45 minutes and 750 calories an an elliptical machine.

I used to feel like crap and had NO energy and got winded so easily until I did. It took me awhile to get into it as the LAST thing I wanted to do was anythinh physical. Since I have been doing it for about two years now, I feel soooo much better than I had in such a long time. Anytime I miss more than a few days, I get to feeling crappy again. Besides feeling physically better, it has improved my mental outlook as well. I used to be prone to depression and the 'poor me' syndrome. That has greatly improved and people tell me I inspire them with my positive outlook on life given all the obstacles I am facing. I have dropped 60 pounds (260 to 200) and got back a lot of the muscle mass that was wasting away. I had an angiogram and and the pressures inside my heart measured two weeks ago as part of a liver pre-transplant workup and the cardiologist said my heart is in as good a shape as when I was born (hope it WAS good when I was born!) I don't need a transplant right now and am not listed but I am starting triple Tx in February and my Hepa is worried it could cause my liver to fail, so she is covering the bases beforehand

Don't know if this would work for anyone else and like they say, talk to your doctor first, but I swear by my workout! My last HgA1c was 6.9 which is a little high, but not too bad. I also have varices and take propranolol to slow my heart rate so I can't work out as hard as I like.

My other secret to a happy life is to get the paper every morning and check the obituaries and if I don't see my name there I know that it'll be a good day!!! Oh yeah, right after that, I turn it all over to God and know that He is the one really in charge.

Good luck to you and your husband, Merry Christmas and keep up the good fight and have faith that between the two of you, you will get it worked out. He is sooo lucky to have you to help him!

God bless,
Chris
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