Hemoglobin A1c levels decreased significantly after viral elimination.
Early treatment and elimination of hepatitis C virus (HCV) with direct-antiviral agents (DAAs) in patients with related cirrhosis may improve glucose tolerance and reduce the risk for diabetes development, according to findings from a prospective study published in Liver International.1
Investigators evaluated the impact of DAAs on glucose control in people without diabetes with HCV genotypes 1a/1b and cirrhosis. Glucose tolerance was assessed by a 2-hour 75-gram glucose tolerance test, with impaired glucose tolerance defined as plasma glucose of 140 to 199 mg/dL.
A total of 32 consecutive outpatients were included and were evaluated at 12 weeks following treatment with a DAA. In addition, researchers estimated each patient’s insulin resistance using the oral glucose insulin sensitivity index.
At the end of the 12-week DAA treatment, all patients had achieved sustained virologic response. Although no significant changes were observed in fasting plasma glucose following viral eradication (103.5±7.1 vs 102.8±7.2 mg/dL, P =.15), there was a significant reduction in 2-hour plasma glucose level from baseline (165.2±22.7 vs 138.5±21.3 mg/dL, P <.001).
In addition, hemoglobin A1c levels decreased significantly after viral elimination (6.1±0.2% vs 5.7±0.3%, P <.001). The oral glucose insulin sensitivity index also demonstrated a strong reduction in insulin resistance at 12-week follow-up (6.92±1.56 vs 9.52±1.39 mg/kg/min, P <.001).
Although the findings of this study demonstrate the potential advantage of HCV eradication with DAAs for reducing diabetes risk, additional research with a longer follow-up period may provide greater insight into the benefits and possible risks associated with treatment in this patient population.