title: Diabetes and Hepatitis C: A Two-Way Association.
abstract: Diabetes and hepatitis C infection are both prevalent diseases worldwide, and are associated with increased morbidity and mortality. Most studies, but not all, have shown that patients with chronic hepatitis C are more prone to develop type 2 diabetes (T2D) compared to healthy controls, as well as when compared to patients with other liver diseases, including hepatitis B. Furthermore, epidemiological studies have revealed that patients with T2D may also be at higher risk for worse outcomes of their hepatitis C infection, including reduced rate of sustained virological response, progression to fibrosis and cirrhosis, and higher risk for development of hepatocellular carcinoma. Moreover, hepatitis C infection and mainly its treatment, interferon α, can trigger the development of type 1 diabetes. In this review, we discuss the existing data on this two-way association between diabetes and hepatitis C infection with emphasis on possible mechanisms. It remains to be determined whether the new curative therapies for chronic hepatitis C will improve outcomes in diabetic hepatitis C patients, and conversely whether treatment with Metformin will reduce complications from hepatitis C virus infection. We propose an algorithm for diabetes screening and follow-up in hepatitis C patients.
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA ; Department of Pediatrics, Oslo University Hospital Ullevål , Oslo , Norway.
authors.forename: Sara Salehi
authors.initials: SS
authors.lastname: Hammerstad
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA.
authors.forename: Shira Frankel
authors.initials: SF
authors.lastname: Grock
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA.
authors.forename: Hanna J
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA.
authors.forename: Alia
authors.initials: A
authors.lastname: Hasham
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA.
authors.forename: Nina
authors.initials: N
authors.lastname: Sundaram
authors.affiliation: Department of Medicine, Division of Endocrinology, Icahn School of Medicine at Mount Sinai , New York, NY , USA ; James J. Peters VA Medical Center , Bronx, NY , USA.
authors.forename: Yaron
authors.initials: Y
authors.lastname: Tomer
keywords: hepatitis C; hepatitis C virus; hepatocellular carcinoma; insulin resistance; interferon alpha; outcomes; treatment; type 1 diabetes; type 2 diabetes