Prevalence of chronic HCV infection in patients with type 2 diabetes mellitus in Russia

Abstract

BACKGROUND: The poor outcomes of chronic hepatitis C (CHC) and type 2 diabetes determine the socio-economic significance of the combined pathology since they lead to premature death. The proportion of patients with type 2 diabetes with markers of viral hepatitis (VH) in the Russian Federation is not known, which does not allow us to estimate the burden for the state of this medical problem.OBJECTIVE: Assessment of the prevalence of concomitant pathology, HCV infection and type 2 diabetes, as well as the proportion of severe liver damage in its structure, according to the analysis of the primary medical records of four Moscow hospitals.MATERIALS AND METHODS: A retrospective analysis of the medical records of patients with HCV infection and diabetes mellitus, who admitted at different periods to four hospitals in Moscow, was carried out, as well as a total examination for the presence of anti-HCV in the blood of all patients with diabetes who were admitted within a certain period to the endocrinology department of a multidisciplinary hospital. Additionally, to determine the proportion of patients with liver cirrhosis (LC), an additional examination of patients with this combined pathology was carried out in accordance with the standards for the diagnosis of hepatitis C.RESULTS: In total, according to data from 4 hospitals in Moscow, over a certain period, 2% (105/5298) of diabetes patients with anti-HCV in their blood were identified. Sex ratio for men: women = 54 (51%): 51 (49%). Patients aged 50–69 years prevailed — 70% (74/105). Seroprevalence of HCV in cohorts of patients with type 2 diabetes according to the analysis in 3 health facilities: 0.9% (20/2196), 1.9% (8/432), 1.9% (28/1500). A significant drawback was revealed that did not allow assessing the true seroprevalence of HCV: not all patients were hospitalized with the results of a VH test, and not all of them were assigned an examination for VH markers if it was not performed before hospitalization. The proportion of type 2 diabetes patients with anti-HCV in the blood according to the results of total screening (3.7%; 16/432) became comparable to the proportion of type 2 diabetes patients among patients with CHC admitted to an infectious hospital (4.2%; 49 / 1170). The proportion of patients with LC according to the analysis of the medical records of the infectious hospital is 65% (32/49), in the group of endocrinological patients with additional examination it is 18% (13/71).CONCLUSION: For the first time in the Russian Federation, data were obtained on the prevalence of HCV infection in combination with type 2 diabetes. The results of the study indicate the need to develop effective screening programs to detect active HCV infection in the group of patients with diabetes, as well as patients among them with severe hepatic fibrosis for the timely conduct of highly effective antiviral therapy, which will prevent poor outcomes in a separate perspective.

Hypothyroidism among Type 2 Diabetic Patients Visiting Outpatient Department of Internal Medicine of a Tertiary Care Centre: A Descriptive Cross-sectional Study

“…This finding was in accordance with these studies. 11 , 12 Another study done in Saudi Arabia also documented similar results. 13 …”

“…This finding was in accordance with these studies. 11,12 Another study done in Saudi Arabia also documented similar results. 13 Furthermore, a cross-sectional observational study among T2DM patients in India found a significantly increased risk of hypothyroidism in the elderly > 65 years.…”

Type 2 Diabetes Mellitus and Thyrotoxicosis Presenting Concurrently

“…Abnormalities were significantly more common in females than in males and in insulin‐treated patients compared with patients on oral hypoglycaemic drugs. Subclinical hypothyroidism was most common (48.3%) followed by subclinical hyperthyroidism (23.1%) and clinical hypothyroidism (4.4%) 14 …”

“…Increased hexose absorption from the intestine in thyroxicosis 2 Reduced responsiveness to insulin in thyrotoxicosis 2,14 Increased release of catecholamines resulting from stress, which in turn causes (a) impaired insulin action on target tissue and increased hepatic glucose production, and (b) impaired disposal of exogenous glucose 2 …”

“…Subclinical hypothyroidism was most common (48.3%) followed by subclinical hyperthyroidism (23 .1 % ) and clinical hypothyroidism (4.4% ). 14 The mechanism underlying impaired glucose tolerance with hyperthyroidism is not completely understood but the following have been suggested: • Abnormal proinsulin levels have been found, which are early markers of beta cell impairment. Proinsulin levels decrease after antithyroid treatment, while they increase in hypothyroid patients after thyroxine therapy.…”