Diabetes Metab J.  2017 Aug;41(4):316-321. 10.4093/dmj.2017.41.4.316.

Factors Associated with Improved Glycemic Control by Direct-Acting Antiviral Agent Treatment in Egyptian Type 2 Diabetes Mellitus Patients with Chronic Hepatitis C Genotype 4

• Dawood AA
• Nooh MZ
• Elgamal AA

• KMID: 2392472
• DOI: http://doi.org/10.4093/dmj.2017.41.4.316

Abstract

BACKGROUND
The association of chronic hepatitis C virus (HCV) infection with type 2 diabetes mellitus (T2DM) was first reported in 1994. Little is known about the effect of direct-acting antiviral agents (DAAs) on glycemic control in T2DM patients. The aim of the present study was to evaluate the factors associated with improved glycemic control (IGC) by DAA treatment in Egyptian T2DM patients with chronic HCV genotype 4 infection.
METHODS
This study included 460 T2DM patients with chronic HCV genotype 4 infection. Four hundred patients received DAAs and 60 patients did not receive DAAs. Patients with sustained virological response after 3 months of DAAs (378 patients) were allocated into two groups: first group included 292 patients (77.2%) with IGC and second group included 86 patients (22.8%) with non-improved glycemic control (NIGC).
RESULTS
In IGC group, 78 patients (26.7%) needed to decrease the dose of antidiabetic treatment. There were no significant differences between IGC and NIGC groups as regards age, sex, and body mass index. The percentage of patients with positive family history of T2DM, those with Child B class and duration of T2DM were significantly higher in NIGC group compared to IGC.
CONCLUSION
Diabetic patients receiving DAAs should be closely monitored for reduction of antidiabetic drugs especially insulin and sulfonylurea to avoid hypoglycemic events. Improvement of glycemic control with DAAs is more in patients without family history of T2DM, short duration of diabetes mellitus, and mild liver disease.

Keyword

Diabetes mellitus; Direct-acting antiviral agents; Hepatitis C virus

MeSH Terms

Antiviral Agents
Body Mass Index
Child
Diabetes Mellitus
Diabetes Mellitus, Type 2*
Genotype
Hepacivirus
Hepatitis C, Chronic*
Hepatitis, Chronic*
Humans
Hypoglycemic Agents
Insulin
Liver Diseases
Antiviral Agents
Hypoglycemic Agents
Insulin

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