Improved glycemic control with eradication of hepatitis C

(HealthDay)—For patients with type 2 diabetes, direct-acting antiviral (DAA) treatment of hepatitis C virus (HCV) is associated with improved glycemic control and reduced antidiabetic medication use, according to a study published online June 28 in Diabetes Care.

Justine Hum, M.D., from Portland Veterans Affairs Medical Center in Oregon, and colleagues identified 2,435 patients with diabetes who underwent interferon-free and ribavirin-free DAA-based antiviral treatment for HCV to examine whether eradication of HCV infection correlates with improved glycemic control. They compared the average hemoglobin A1c (HbA1c) level and use of antidiabetic medications one year before and after antiviral treatment for patients who achieved and did not achieve sustained virologic response (SVR).

The researchers found that for patients with elevated baseline HbA1c, those who achieved SVR had a greater drop in HbA1c associated with antiviral treatment than those who sustained treatment failure (0.98 versus 0.65 percent; adjusted mean difference, 0.34). Compared with patients who sustained treatment failure, those who achieved SVR had more of a decrease in antidiabetic medication use, especially for use of insulin, which decreased significantly from 41.3 to 38 percent in patients achieving SVR versus an increase from 49.8 to 51 percent in those who sustained treatment failure.

"These endocrine benefits of SVR provide additional justification for considering antiviral treatment in all patients with diabetes," the authors write.