Abrupt onset of diabetes during interferon-alpha therapy in patients with chronic hepatitis C.
BACKGROUND
Interferon-alpha (IFN-alpha) is now widely used in the treatment of chronic hepatitis C. Few patients have been reported as developing impaired glucose tolerance or diabetes mellitus (DM) using this therapy. The explanation for the development of DM in chronic hepatitis C treated with IFN-alpha is unclear. We report two patients who developed an abrupt onset of diabetes during IFN-alpha for chronic hepatitis C.


METHODS
Two male middle-aged patients were admitted to our hospital for an abrupt onset of diabetes, in diabetic ketoacidosis, with a very short duration of hyperglycaemic symptoms. Their clinical course was similar. Case 1 never demonstrated any markers of pancreatic immunogenicity. Case 2 had high levels of decarboxylase glutamic acid autoantibodies (GADAb), before the IFN-alpha treatment that persisted. We compared initial beta-cell function and metabolic control with a group of middle-aged patients from our hospital who had recently been diagnosed with Type 1 diabetes mellitus (DM1). In contrast to these, the onset of the disease was particularly severe with beta-cell function substantially impaired and displaying unstable short-term metabolic control.


CONCLUSIONS
Type 1 diabetes should be considered as a potential complication if IFN is administered to patients with chronic hepatitis C. Its onset may be severe and result in short-term difficulties in metabolic control.
Recasens
M
M
Endocrinology and Diabetes Unit, IDIBAPS, Hospital Clínic i Universitari, Barcelona, Spain.
Aguilera
E
E
Ampurdanés
S
S
Sánchez Tapias
J M
JM
Simó
O
O
Casamitjana
R
R
Conget
I
I
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000209:etiology*; D016883:Diabetic Ketoacidosis / Q000209:etiology; D005968:Glutamate Decarboxylase / Q000276:immunology; D019698:Hepatitis C, Chronic / Q000628:therapy*; D006801:Humans; D006943:Hyperglycemia; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D011994:Recombinant Proteins; D013997:Time Factors
D001323:Autoantibodies; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D005968:Glutamate Decarboxylase