Markedly Improved Glycemic Control in Poorly Controlled Type 2 Diabetes following Direct Acting Antiviral Treatment of Genotype 1 Hepatitis C

Abstract

Type 2 diabetes mellitus (T2DM) is often associated with hepatitis C virus (HCV) infection. Successful HCV treatment may improve glycemic control and potentially induce remission of T2DM. We report a case of an obese 52-year-old woman with mixed genotype 1a/1b HCV infection with compensated cirrhosis and a 10-year history of poorly controlled T2DM on insulin therapy. Following successful therapy with sofosbuvir, simeprevir, and ribavirin, her insulin requirements decreased and her glycosylated hemoglobin (HgA1c) normalized despite weight gain. This case suggests an association between HCV and T2DM and the potential for significant improvement in glycemic control with eradication of HCV.

The Effect of Hepatitis C Virus Eradication with New Direct Acting Antivirals on Glucose Homeostasis in Non-Diabetic Egyptian Patients

“…This is in agreement with several studies [12,[15][16][17]. Abdel Alem et al, found a reduction in both FBS and HbA1c after HCV eradication [18].…”

Hepatitis C Virus Eradication with New Interferon‐Free Treatment Improves Metabolic Profile in Hepatitis C Virus‐Related Liver Transplant Recipients

“…(4)(5)(6)(7)(8)41) A direct causal relationship between recurrent HCV infection and onset of PTDM is supported by evidence that viral eradication leads to restoration of insulin sensitivity, improved diabetic control, and improved renal function. (19,(22)(23)(24)(25)(26)38) Restoration of insulin sensitivity has been demonstrated in nontransplant patients following HCV eradication with IFN-based therapy. (25)(26)(27)(28)(29)35) This is the first study to report the favorable effects of DAAs on PTMS in liver transplant patients with recurrent HCV infection.…”

“…(19,(22)(23)(24)(25)(26)38) Restoration of insulin sensitivity has been demonstrated in nontransplant patients following HCV eradication with IFN-based therapy. (25)(26)(27)(28)(29)35) This is the first study to report the favorable effects of DAAs on PTMS in liver transplant patients with recurrent HCV infection. The impact of viral eradication on metabolic parameters was higher among patients infected with HCV GT1 than those infected with HCV GT3 in this study, consistent with other reports, (42,43) and may reflect genotypic-specific effects on lipid profile and insulin resistance.…”

“…(23) Subsequent studies have demonstrated sustained improvement in insulin sensitivity and diabetic control following HCV eradication following both interferon (IFN)-based and IFN-free antiviral therapy. (24)(25)(26)(27) This current study determines the effect of successful DAA treatment on glycemic control, blood pressure, lipid profile, and renal functions in posttransplant HCV recipients.…”

Treatment of Chronic Hepatitis C Can Improve Glycemic Control in Patients with Type 2 Diabetes

“…There are clinical case reports showing that FG and HbA1c recover after HCV eradication has been achieved [6, 7]. It has been suggested that coexisting diabetes or hyperlipidemia might interact with the response to DAAs and patients with blood glucose <126 mg/dl had a higher virologic response [8].…”