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Diabetes With HCV

A good reason to get diabetes treated as well as the HCV

http://www.thedoctorschannel.com/video/4559.html
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Avatar universal
The link is for the video.  Here is the introduction.

"""NEW YORK (Reuters Health) – Patients with type 2 diabetes who also have liver cirrhosis associated with hepatitis C virus (HCV) infection fare significantly better when they’re treated with metformin, results of a French study indicate.

“We found that metformin treatment was independently associated with a decrease in HCC (hepatocellular carcinoma) occurrence and with a decreased rate of liver-related death,” the researchers report in the August issue of the Journal of Clinical Endocrinology and Metabolism.

The authors point out that type 2 diabetes and hyperinsulinemia are common in patients with HCV cirrhosis, and that there’s evidence indicating that insulin resistance plays a role in the development of liver cancer. Therefore, treatment with metformin could be beneficial in this setting.

To investigate, Dr. Emmanuel Cosson, with Hopital Jean Verdier in Bondy and Paris-Nord University, and colleagues studied a prospective cohort of 100 consecutive patients with ongoing HCV cirrhosis and type 2 diabetes, 26 of whom were treated with metformin.

During follow-up for a median of 5.7 years, 39 patients developed HCC and 33 either died of liver-related causes or underwent a liver transplant, according to the report.

The team found that the 5-year rate of HCC was 9.5% among the group receiving metformin compared with 31.2% in those who did not. On multivariate analysis, metformin was independently associated with reduced risk of HCC (hazard ratio 0.19, p=0.023).

Similarly, the corresponding rate of death or transplantation was 5.9% vs 17.4% in the two groups, respectively. This translated to an adjusted hazard ratio for death/transplantation of 0.22 (p=0.049), Dr. Cosson and colleagues report.

They note that this was an observational study, so cause and effect cannot be determined. “However,” they conclude, “our findings add to the increasing body of evidence and may justify the initiation of clinical trials evaluating metformin in patients with hyperinsulinemia and HCV cirrhosis.”

Reference:
Impact of Metformin on the Prognosis of Cirrhosis Induced by Viral Hepatitis C in Diabetic Patients
J Clin Endocrinol Metab 2011;96.
1765684 tn?1333822768
I'm quite interested in the association between diabetes and HCV.  However, all the research seems to be with type 2 diabetes, either 'caused' by HCV treatment or in association with HCV chronic infection.

I wonder how many people there are who have HCV and were diagnosed with type 1 diabetes as adults...  I was diagnosed with type 1 in my early 20s.  If I was infected with HCV when I think I was (tattoo in the early 80s), then my diagnosis of type 1 diabetes came a couple of years later.

The liver stores sugar.  In a person without T1 diabetes, the pancreas continually shoots out insulin through the day and the liver shoots out sugar stores.

If there is damage to the liver, I imagine that process doesn't work as it should...
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