<< Back to InfosheetsDiabetes Type II and Hepatitis C Hepatitis C Virus (HCV) and Diabetes Type II is a serious combination. A study from John Hopkins University showed that people age 40 or over who are Hepatitis C (HCV) positive have over three (3) times the risk of developing Type 2 Diabetes. Another case control study of HCV patients without advanced liver disease (cirrhosis) on liver biopsies showed that a third of HCV infected patients had type 2 diabetes - a remarkable increased prevalence not found in patients with chronic hepatitis B matched studies. Chronic hepatitis C is specifically and frequently associated with diabetes, regardless of the presence of liver cirrhosis (advanced liver disease). When cirrhosis is HCV - related, the risk of diabetes is even higher and post transplantation diabetes is also significantly more common in patients whose liver failure was due to HCV. However, while HCV infection increases the risk of diabetes, Hepatitis B (HBV) infection does not. Recent research findings are consistent with past studies showing that HCV infection is highly associated with diabetes. For instance among 4,958 people age 40 or older without diabetes, 3,486 tested negative and 812 tested positive for HCV. Another 116 subjects were infected with both HCV and HBV infection and 544 tested positive for hepatitis B. A total of 474 people developed diabetes during the 7 years that they were followed. After adjusting the data to account for established diabetes risk factors, the incidence of diabetes was 70 percent higher in persons with HCV infection than in those without HCV infection. There are even some studies that suggest Hepatitis C plays a causative role for the development of Diabetes Mellitus, known as Type 2 diabetes. This may be in part due to the suspected mechanism of hepatic injury in patients with fatty liver, which involved insulin resistance. This theory is supported by the fact that glucose intolerance improves after successful antiviral treatment for Hepatitis C. Interestingly, genotype's 3 which accounts for about 5% of the US Hepatitis C population has a disproportionate amount of patients with steatosis (Fatty Liver). This is felt to be the reason that these patients do not respond as well to antiviral treatments. Liver disease is the leading cause of death among people with type 2 diabetics than cardiovascular disease. While there are many different types of liver disease, the ones that can occur in diabetics include nonalcoholic fatty liver disease, cirrhosis (advanced liver disease) of the liver and hepatocellular carcinoma (liver cancer). As such, Diabetics also face an increased risk of hepatitis C and acute liver failure. DIABETES TYPE 2 Type 2, or adult onset diabetes, occurs when the body's cells ignore the insulin, and glucose levels remain increased, resulting in "insulin resistance". Insulin is a hormone produced by the pancreas to control blood sugar that is needed to convert sugar, starches and other food into energy needed for daily life. The role of insulin is to move glucose from the bloodstream into muscle, fat, and liver cells, where it can be used when needed. When glucose builds up in the blood instead of going into cells, it causes risks for:
The cause of diabetes is still unknown; lack of exercise and obesity appear to play key roles. However, as the above studies have shown hepatitis C can now be added to this group. HEPATITIS CVIRUS (HCV) Formerly known as non- A, non- B hepatitis, is a serum hepatitis caused by the hepatitis C virus. Approximately 80% of those infected with HCV develop chronic hepatitis C, with an uncertain number progressing to cirrhosis, liver failure and hepatocelular carcinoma. Although HCV is a blood borne infection, transmitted through blood to blood contact, approximately 40% of the patients do not fall into identified risk factors. Advanced tests called PCR amplification and DNA assay are used to determine the level of hepatitis virus in the blood. WHAT SHOULD I DO IF I KNOW HAVE HEPATITIS C, DIABETES TYPE II OR BOTH? If you have either Hepatitis C, Diabetes Type II or both LOLA recommends you speak to your doctor about what are the best treatments available to help control your disease or combination of both. If you need a doctor referral or seek further information you can contact LOLA at 718-892-8697. WHAT ARE THE COMPLICATIONS OF HAVING BOTH HCV AND DIABETES TYPE II? Diabetes Type II can be made worse by treatment with interferon for HCV so blood sugars need to be monitored closely during therapy. Both conditions can cause fatigue, renal and skin problems and weight gain. WHAT CAN HAPPEN IF I ONLY TREAT HCV AND NOT THE DIABETES TYPE II? The Diabetes Type II can continue to cause problems with kidneys, eyes, etc. It may also be associated with fatty liver disease that continues to progress and lead to worsening liver disease and liver scarring (Fibrosis /Cirrhosis) despite a good response to HCV treatment. Resources- 1) The John Hopkins University Study 2)Tumor Necrosis Factor (TNF) - chronic hepatitis C and diabetes: A Novel Triad" by Dr. K. Knobler and Professor A. Schattner 3) Dr. Chong-Shan Wang -National Yang-Ming University, Taipei, and colleagues in the American Journal of Epidemiology in July of 2007 4) The Annals of/nternal Medicine. Special thanks to LOLA Medical Advisory Members Dr. Mark Avila and Dr. Thomas Schiano.© Copyright 2008 - The Latino Organization for Liver Awareness |