AASLD 2016: The Liver Conference
Source: Abstract # 964:
Viral response to hepatitis C direct-acting antivirals significantly improves diabetes control—S B LeCler at. al
Insulin resistance is believed to be caused by the hepatitis C virus. But diabetes is not believed to cause diabetes. But does successful treatment help to reduce some measurements of the disease? This is what the study examined. The study looked at the effect of direct-acting antiviral (DAA) treatment on diabetic medications. The authors identified studies from February 1, 2014 through October 1, 2015 that included 131 patients who received DAA treatment and who also received diabetes medications.
The majority of the patients were male (98%), the average age was 63, and the majority of patients were black (59%) and had advanced fibrosis (53%).
Conclusions: Of the 122 patients who achieved a cure 27% (33 of 122 patients) lowered their diabetic medications from baseline measurement to 3 months post-treatment compared to 11% (1 of 9 patients) of the HCV DAA replaspers who did not. Of the available data on A1C—A1C is an average measurement of glucose over a three-month period—there was a significant decrease of 0.63% percentage points.
Editorial Comments: This is a small but interesting study. It needs to be replicated in much larger studies to confirm the results. Anecdotally, I hear from many people that being cured has helped to improve their blood sugar levels. Patients would certainly benefit from monitoring their blood sugar levels after being cured and working with their medical providers to find out if their diabetes medications need to be adjusted.
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Alan Franciscus is the Executive Director of the Hepatitis C Support Project and the Editor-in-Chief of the HCV Advocate Website.
Note: Another reason we should be treating as soon as people are diagnosed with hepatitis C. Alan
For hepatitis C virus-infected patients, diabetes mellitus is associated with increased risk of hepatocellular carcinoma development and all-cause mortality, according to a study published online Dec. 8 in the Journal of Gastroenterology and Hepatology.
MONDAY, Dec. 19, 2016 (HealthDay News) — For hepatitis C virus (HCV)-infected patients, diabetes mellitus (DM) is associated with increased risk of hepatocellular carcinoma (HCC) development and all-cause mortality, according to a study published online Dec. 8 in the Journal of Gastroenterology and Hepatology.
Ting-Shuo Huang, M.D., from the Chang Gung Memorial Hospital in Keelung, Taiwan, and colleagues used data from the Taiwanese National Health Insurance Research Database to evaluate the effect of DM on the development of HCC and on the transition from HCC to death. Newly diagnosed DM patients with HCV were enrolled and were propensity-score matched with HCV patients without DM (1,686 patients in each cohort).
BOSTON, MA—Among patients with diabetes, HbA1c significantly improved with hepatitis C virus (HCV) clearance, a retrospective cohort study presented at The Liver Meeting® 2016 concluded.
In fact, an “HbA1c reduction of 0.63 percentage points was achieved, which is similar to improvements seen in antidiabetic medication trials,” noted Sheena LeClerc, PharmD, of the department of gastroenterology at the Louis Stokes Veterans Affairs Medical Center in Cleveland, OH, and coauthors.
Of the 2.7 to 3.9 million cases of chronic HCV in the United States, 15% to 50% of patients also have a diagnosis of type 2 diabetes (T2DM). Some studies have demonstrated an association between HCV and progression of insulin resistance to T2DM as well as improved virologic response from treatment for HCV.