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A link between diabetes and hepatitis C

by: Peduli Hati Bangsa team (May 2024)

The hepatitis C virus (HCV) spreads through contact with blood. This can cause acute or chronic infections. If HCV becomes chronic, the infection can cause liver damage and the development of other conditions, including diabetes.

Numerous studies show a correlation between HCV and diabetes. Up to 33% of people with chronic HCV also have diabetes.

In this article, we will look at the link between hepatitis C and diabetes, including the relationship between the two conditions, their treatment, and their management.

Can HCV cause diabetes?

According to a 2017 study, people with chronic HCV are more likely to develop type 2 diabetes and insulin resistance compared to people who do not have the virus. They are also more likely to develop diabetes than people with hepatitis B, another virus that affects the liver.

To understand how HCV may contribute to diabetes, it is important to understand how the disease develops.

When someone consumes carbohydrates, the body will convert them into glucose. The glucose enters the bloodstream. The increase in the amount of glucose in the bloodstream then triggers the release of insulin from the pancreas. This insulin then helps cells absorb glucose and use it as energy.

If there is more glucose in the blood than the body currently needs, it will be stored for later use by the liver. However, if the liver does not function properly due to HCV infection, then the liver cannot do its job as well as usual. This causes high blood glucose levels.

There are several ways HCV can damage liver function thereby contributing to diabetes, according to a review conducted in 2015, HCV can cause:

  • chronic inflammation
  • steatosis (fat buildup abnormally in the liver)
  • scarring of the liver (cirrhosis), which reduces liver function
  • hepatocellular carcinoma, a type of liver cancer

This condition interferes with the liver’s ability to remove excess glucose from the blood. It can also interfere with insulin release, further increasing blood glucose levels. Over time, this can lead to type 2 diabetes.

Can diabetes cause hepatitis?

Numerous studies show that there are higher HCV prevelance among diabetic patient. But it is unclear of how it happens

A 2019 study from Brazil found that people living with diabetes for more than 5 years had a greater chance of developing HCV. A 2015 review noted that previous studies in the United States, Taiwan, and Italy also found that HCV was more common in people with type 2 diabetes.

The reasons are unclear, but it may be due to increased exposure to needles during emergency situations. More research is needed to understand the connection.

Can hepatitis C worsen existing diabetes?

People with diabetes must maintain a balance of insulin and blood sugar levels to manage the condition. This is known as maintaining glycemic control. Typically, people achieve glycemic control by closely monitoring insulin and blood sugar levels, and by receiving insulin injections.

Research in 2017 stated that HCV infection can reduce glycemic control which can worsen diabetes. However, the researchers found that people with HCV and diabetes who received antiviral treatment experienced significant improvement, and as a result, they required less insulin.

Treating diabetes and hepatitis C

Although diabetes cannot be cured, HCV can be treated. Doctors usually prescribe antiviral drugs (Direct Acting Antiviral/DAA) for HCV, which successfully eliminate the virus in more than 90% of cases with few side effects. Most treatment programs last 8-12 weeks.

Early HCV testing and treatment is critical, especially for those who have or are at risk of developing diabetes. However, DAA treatment can cause changes in insulin or blood sugar levels when the virus clears, which can cause unexpected symptoms.

Therefore, people with HCV and diabetes should monitor their blood sugar levels carefully during HCV treatment, and immediately notify their doctor if they experience symptoms of blood sugar levels that are too high or low. If DAA treatment improves the diabetes, then the doctor may need to adjust the amount of insulin taken.

Whether someone is on HCV treatment or not, managing diabetes can become more complicated if someone has the virus, because of the impact diabetes has on the liver.

Long term complication

People with chronic HCV and diabetes have an increased risk of developing long-term complications, including cirrhosis.

Cirrhosis occurs when an overworked liver tries to heal itself. When trying to repair any damage, the liver forms scar tissue. Scar tissue can reduce liver function and can lead to liver failure. If this happens, the only medicine that can cure it is a liver transplant.

Other cirrhosis complications include:

  • high blood pressure
  • edema
  • malnutrition
  • higher infection risk
  • toxic buildup
  • jaundice
  • bone disease
  • liver cancer
Managing diabetes and HCV

There are a number of things people with diabetes and HCV can do to manage their conditions and reduce the risk of complications. Some of these changes may also help reduce the chance of developing diabetes.

Those changes can be:

  • Avoid alcohol, it can cause liver damage
  • Consuming balance diet of low sugar, fat and sodium
  • Maintain healthy body weight
  • Quit smoking
  • Exercise regulary every day for minimum 30 minutes
  • Get yourself hepatitis C and B vaccine
  • Test for HIV, because co-infection of HCV and HIV can cause cirrhosis

Because HCV is spread through contact with blood, it is important for people with diabetes to dispose of sharp objects, such as syringes, in a safe sharps container. Never share needles or blood glucose monitors with other people.

When to seek medical advice?

Anyone who has HCV and diabetes should contact a doctor to receive antiviral treatment. If someone with HCV is concerned that they have diabetes, they should also consult a doctor as soon as possible.

Diabetes symptoms may include:

  • Fatigue
  • Increased thirst and frequent urination
  • Excessive hunger
  • Unexplained weght loss
  • Blurry vision
  • Experiencing mood swings
  • Frequent skin infections
  • Slowly healed wounds.

If someone with diabetes and HCV experiences the following symptoms, consult a doctor immediately:

  • Abnormal bleeding
  • Jaundice
  • Disorientation
  • Hypersomnia
  • Edema
  • Fruit smell breath
  • Difficulty breathing

Chronic HCV infection can increase a person’s risk of developing diabetes. This is caused by the impact of the virus on the liver, which plays a role in storing and processing glucose. If the liver cannot function as it should, this can lead to high blood glucose levels and insulin resistance.

Because of the correlation between HCV and diabetes, doctors should regularly perform diabetes tests on HCV patients. The best way to reduce the risk of HCV-related diabetes, and prevent the virus from worsening existing diabetes, is to treat the infection as soon as possible. Successful treatment can result in improved glycemic control.

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