HR -- can HCV help cause Type II diabetes

[kittyface]

Hi HR, I was just diagnosed with extreme diabetes mellitus.  I have no family history, am in good physical shape and eat healthily for the most part.  

One of the liver's functions is release glycogen in the blood stream so I'm wondering if HCV can predispose one to diabetes?

Thanks for your help.

Kittyface

[pigeonca]

I suspect that hcv - in conjunction with my genetic makeup - caused my diabetes, especially considering the fact that it's better with SVR.  My highs, 1 or 2 hours after eating, never exceeded 255, and my fasting blood sugar never exceeded 115 and was usually normal.  But if you go over 200 at any time, you're considered diabetic.  The reason mine is considered to be in the early stages is because my fasting numbers have always been below 126, which is the threshhold for a diagnosis of diabetes based on fasting blood sugar alone.  So you see why fasting blood sugar tests are inadequate.  They can be normal long after developing postprandial scores of 200 or more.

I don't think I can cure my diabetes, but I can control it.

[kittyface]

Thanks for your comment and for info about post meal sugar levels.  I will check out both sites and figure out what makes me soar.  I'm hoping to cure diabetes when I SVR.

What are your numbers before and after tx?  Do you think HCV caused early diabetes?

Best to you,

Kittyface

[pigeonca]

I developed diabetes several years before my diagnosis of hcv.  Now, with an SVR, I find that my blood glucose numbers are considerably lower than they were before, although not normal.  Like you, I'm of normal weight and a healthy eater.  But diabetes does run in my family, including some of the thin folks.

I'm taking lantus insulin every evening about an hour or two before bedtime.  That plus metformin do the trick.  Also, I've learned which foods elevate my glucose the most and either avoid or limit them.  Chinese and Indian food are the worst for me, which is unfortunate because I love both cuisines.  But certain dishes are better and certain dishes are worse.  Generally foods with flour or cornstarch gravies are as bad as bread, pasta or potatoes, if not worse.

It's great that you have a meter.  You need to check your blood sugar an hour after eating and then an hour after that to see what various foods do to you.  The American Diabetes Assn. and the American College of Endocrinologists have different standards, and I would recommend those of the latter, as they are more stringent.  Basically, 140 to 160 an hour after a meal, 120 two hours after a meal represent numbers you need to attain.  In the morning your glucose shouldn't be higher than 100.  OTOH, if you're a late onset type 1 diabetic, the numbers can be somewhat higher.

Good luck to you.

[kittyface]

Yes, thanks, I have two of those monitoring systems now.  

I'm at optimal weight, work out, eat healthy food and have no family history of diabetes.  I'm hoping when I SVR the diabetes will disappear.

BTW, did you see new-sojourn's post about geno 2b's virus break through several years later?  What do you make of that?

KIttyface

[Hepatitis Researcher]

You are probably also aware that you can buy, for very litle money, a blood glucose self test apparatus, that almost all diabetics use nowadays, for self control.
Are you overweight? Diabetes in the family?

[kittyface]

Could you please send me a bill in the morning?    :)  

I'll print your post for doctor.  She never mentioned the stix and is trying to control by pills only although I don't mind the needles.  

I can't begin to express my appreciation for the generosity and care you show for us. You are my hero.  What do you want for Christmas?

Best regards,
Kittyface

[Hepatitis Researcher]

This diabetes situation sounds serious and needs to be brought under control before starting tx. 300 fasting glucose is not an acceptable number. You need a diabetologist and frequent care/visits until you are stabilized.

Get the urinary test stix for glucose, these must never be positive, it is a little thing that you can do to monitor for excessive deviations of glucose control. If the stix are neg it does not mean everything is ok.

Glucophage/metformin affects glucose metabolism and insulin response in several ways, both in the liver as well as in the muscles.

It increases glucose uptake by increasing availibility of the Glut4 insulin responsive transporter in muscle cells, thus increasing insulin response/sensitivity,

it activates cellular kinases (phosphorylases) that mediate the effects of insulin, thereby increasing insulin sensitivity,

it inhibits gluconeogenesis from protein in the liver by inhibiting a key enzyme in this pathway, this way lowering glucose production and levels,

it inhibits complex I of the mitochondrial electron transport chain, thus lowering excessive mitochondrial potential in case of high glucose in cells passivly overloaded with glucose in case of hyperglycemia.

It has one dreaded potential side effect, that can be deadly : Lactic acidosis. Kidney function must be carefully checked, creatinine levels must be below 1.2 mg/dL and you cannot use it in case of severe hepatic insufficieny, since the liver has to normally use and remove/metabolize  the excessive lactic acid that accumulates from anerobic muscle activity. Any crush diet must also be avoided, this is important because type II diabetics should get slim of course, but be very careful while on Metformin.

Other than mild cases of type II diabetes, metformin should ideally be combined early with insulin shots, this is the healthiest way to treat type II diabetes, although most patients like the idea " I can nicely control it with pills" better. They are quite mistaken, the early use of insulin in this indication slows the loss of residual pancreatic function and also the use of the sulfonylurea insulin releasing drugs is accompanied by negative side effects on the heart and a more rapid progression of loss of beta cells due to excessive use of reserve insulin. You can whip a tired horse and it will run faster for a while, only to finally completely break down.

[kittyface]

Thanks for all your comments and well wishes.  I went in complaining of sudden onset blurred vision and not feeling well -- dx with blood sugar reading of 530.  Gave me two shots of insulin and now glucophage pills and still in 300's level.  Normal is 90's.

I'm about to tx with the triple threat and hope this dx doesn't contraindicate SVR.  Will research archives.

HR - I'm waiting blood work results and all I know now is blood sugar is high.  Tx plan is hit it heavy with glucophage, diet, exercise and insulin shots if that fails.   BTW, do you know what body system glucophage affects?  Pancreas, intestines, or cells?   I appreciate you all.

Kittyface

[Hepatitis Researcher]

HCV and the bodywide enhanced inflammatory condition, particularly also in the pancreas, generates an additional risk factor for type II diabetes.
Inflammation fosters insulin resistance.
Obesity fosters insulin resistance.
The basic propensity is genetically determined.
HCV and obesity and bad eating habits will bring it to a clinical stage earlier, sometimes much earlier.

What is your current HBA1c ?
Glusose levels fasting and postprandial.?
What treatment is envisioned?

[dperry10]

I too was diagnosed with Type II diabetes a few years after finishing treatment.   I just completed my 2nd go round, and while on treatment, my sugar was absolutely normal.  Doc took me of of the amaryl I was on.     So I am on my 2nd week off treatment, and we will see what happens.  I lost over 100 lbs while on treatment and plan to keep that off.. Thats what I gained after treatment last time.    I am pretty much normal of where I should be.  Until of course I get rid of the excess skin I have everywhere.  Then I may look too skinny..  But time will tell if I can keep the weight off, and maintain my sugar at a normal level.    I wish you luck on treatment with diabetes, it definately was a challenge if I did not feel like eating when I first started, but as time went on, my sugar was normal anyway.. you should be fine, but just keep an eye on your levels and keep a log so you can show your doctor..

[GrandmaA]

Yes, two of my friends ended up with diabetes II after tx. One was overweight. Being overweight seems to increase the risk. I tired to cut down on the sugar during tx. It also doesn't run in my family. Sorry to hear you got that illness. I hear eating is quite a challenge.

[Upbeat]

In a word Yes.
                       What is extreme?  What are your blood sugar reading?

                                                                                                                Ron

[Myown]

Sorry to hear this kitty.