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Hepatitis C and diabetes: one treatment for two diseases?

Venessa Pattullo1, Jenny Heathcote

  • 1Division of Gastroenterology, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Liver International : Official Journal of the International Association for the Study of the Liver
|December 31, 2009
PubMed

Insights

Chronic hepatitis C (CHC) is linked to higher rates of type 2 diabetes mellitus (T2DM) and insulin resistance (IR). This review explores the impact of glucose metabolism issues in CHC and potential treatment questions.

Area of Science:

  • Hepatology
  • Endocrinology
  • Virology

Background:

  • Epidemiological data show a strong association between chronic hepatitis C (CHC) and impaired glucose homeostasis.
  • Individuals with CHC exhibit higher prevalences of type 2 diabetes mellitus (T2DM) and insulin resistance (IR) compared to the general population and those with other chronic liver diseases.
  • Insulin resistance and diabetes negatively impact patient outcomes in all stages of CHC, including liver transplant recipients.

Purpose of the Study:

  • To review the impact of glucose homeostasis abnormalities in CHC.
  • To identify individuals at risk for diabetes in the CHC population.
  • To explore potential benefits of managing IR and T2DM on CHC progression, treatment response, and overall patient outcomes.

Main Methods:

  • Literature review of epidemiological data and clinical studies.
  • Analysis of the relationship between CHC, IR, and T2DM.
  • Discussion of potential therapeutic interventions and future research questions.

Main Results:

  • CHC is independently associated with increased risk of IR and T2DM.
  • IR and T2DM exacerbate liver disease progression, reduce antiviral treatment efficacy, and increase hepatocellular carcinoma incidence.
  • Current evidence for pharmacotherapy or lifestyle interventions targeting IR in CHC is limited.

Conclusions:

  • Abnormalities in glucose homeostasis are a significant concern in CHC patients.
  • Further research is needed to determine optimal strategies for identifying, preventing, and treating IR and T2DM in CHC.
  • Investigating the potential for a dual treatment approach for both CHC and diabetes warrants consideration.

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