REPLACING INSULIN WITH ANTI-VIRALS: A CLINICAL VIGNETTE ON DIABETES AND HCV TREATMENT

AACE Clinical Case Reports
Justin BerkSara Mixter

Abstract

There is growing evidence to support a connection between type 2 diabetes mellitus (T2DM) and chronic hepatitis C virus (HCV). Patients with hepatitis C have a substantially higher risk for developing type 2 diabetes and recently there have been several proposed mechanisms. Several retrospective studies have demonstrated a small but significant improvement in glycemic control after treatment of underlying hepatitis C virus. We describe a case that demonstrates the greatest recorded improvement in glycemic control after treatment of HCV in the setting of self-discontinuation of insulin therapy without behavioral modification. A 38-year-old obese female with uncontrolled T2DM (hemoglobin A1c [HbA1c] of 11.6% [103 mmol/mol]) was temporarily lost to follow-up and reported nonadherence to insulin therapy, metformin therapy, diet, or exercise. During this time, she was successfully treated for hepatitis C and became euglycemic without other interventions. The patient's HbA1c decreased from 11.6 to 5.7% (103 to 39 mmol/mol) in the presence of weight gain and in the absence of any intervention other than hepatitis C treatment. Hepatitis C treatment may offer significant potential for improving insulin sensitivity and decreasing long-te...Continue Reading

References

Jun 28, 2003·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Shruti H MehtaDavid L Thomas
Jul 8, 2009·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Ester VanniElisabetta Bugianesi
Apr 13, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Adeel A ButtAbdul-Badi Abou-Samra

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