Glycemic control in type 2 diabetes mellitus and new hepatitis C virus genotype 4 therapy

Abstract

Objective The aim of this study was to evaluate the effect of glycemic control on the response to new therapy for hepatitis C virus infection (HCV) and the impact of the new HCV therapy on glycemic control in type 2 diabetes mellitus (T2DM) patients. Background HCV genotype 4 is prevalent in the Middle East, in Egypt, and in Central Africa. It is associated with an increased risk for T2DM as it causes insulin resistance. Direct pancreatic β-cell destruction, autoimmune injury, and other mechanisms associated with HCV are not entirely clear. HCV genotype 4 patients can be treated with interferon-free direct antiviral agents such as sofosbuvir (400 mg) and daclatasvir (60 mg) given daily for 12 weeks with or without ribavirin. Patients and methods Our study included 359 HCV patients who were divided into nondiabetic patients, controlled diabetic patients, and uncontrolled diabetic patients. These patients received anti-HCV treatment in Shebin El-Kom Teaching Hospital. They underwent tests for evaluation of glycated hemoglobin, HCV PCR, random blood sugar, liver function, creatinine levels, complete blood count, α-fetoprotein levels, and thyroid-stimulating hormone levels and an abdominal ultrasound. Results There was a highly significant response to HCV treatment in the nondiabetic group and a highly significant relapse in the uncontrolled diabetic group. There was also a highly significant decline in glycated hemoglobin levels at the end of treatment in both controlled and uncontrolled diabetic patients. Conclusion The successful treatment of HCV using new interferon-free direct antiviral agents has a significant beneficial effect on glycemic control in T2DM patients and also on thyroid-stimulating hormone levels.