Prevalence of Diabetes Mellitus in Newly Detected Patients with Hepatitis C

Introduction: Hepatitis C, in addition to liver disease, also causes extrahepatic manifestations in almost 35% of patients, resulting in a spectrum of autoimmune conditions. The prevalence of type 2 diabetes has been reported to be more in these patients. There is a compelling reason to believe this because studies have shown an increased prevalence of hepatitis C virus (HCV) in type 2 diabetes mellitus (DM). The study was conceived to find the prevalence of type 2 DM in HCV-positive patients and its relation to genotype. Materials and Methods: This was a hospital-based case-control study, conducted in the Department of Gastroenterology, Government Medical College Srinagar, Jammu and Kashmir, India. All patients with hepatitis C were enrolled and investigated as per the study design. According to the standard protocol already in vogue, the cases were thoroughly investigated which included all base line investigations, GTT, HbA1c and HOMA-IR. However, majority of the controls were subjected to GTT, HbA1c and homeostatic model assessment of insulin resistance (HOMA-IR) only. Results: Among the cases, the mean age was 45.97 +/- 11.982 years; 67.14% had genotype 3 and 32.85% had genotype 1. Cases and controls were compared on the basis of fasting blood sugar levels in three different ranges (<= 100 mg%, 101-125 mg%, and >= 126 mg%) and a 2-h GTT at three different levels (<140 mg%, 140-199 mg%, and >= 200 mg%). Other parameters of comparison included HbA1c, serum insulin levels, HOMA-IR, body mass index, liver function test, and lipids. Among all these, only the difference in the level of HOMA-IR (<2.5 in 45.71% of cases and 65.71% of controls) was statistically significant (P = 0.0063). On comparing the diabetogenic potential of two genotypes on the basis of fasting blood sugar and a 2-h GTT, genotype 3 was found to be more diabetogenic. Conclusion: Hepatitis C causes 2.1-fold increase in the prevalence of type 2 diabetes in patients without the evidence of chronicity or complications with increased predisposition to genotype 3 over genotype 1.