Direct-acting antiviral agents lower HbA1c in diabetic patients with HCV virus
Diabetic patients with hepatitis C virus (HCV) may benefit from direct-acting antiviral agents, with a significant portion of patients having a clinically significant reduction in glycated haemoglobin (HbA1c), suggests a recent study. This effect has been sustained among responders over 1.5 years of follow-up.
HbA1c was 8.4±1.9 percent at the nearest time point before treatment compared with 7.8±1.7 percent after treatment (mean difference, 0.6 percent, 0.2–0.9; p<0.01). In a linear mixed effects model that incorporated each patient’s repeated measurement over time, a reduction was also seen after treatment (mean difference, 0.5 percent, 0.3–0.8; p<0.001).
Forty-two of 122 (34 percent) patients showed an improvement in diabetes after HCV treatment, when accounting for both HbA1c and diabetes medications. Furthermore, 20 of 28 (71 percent) of these patients sustained the improvement at 1.5 years follow-up.
Moreover, insulin prescription led to improved diabetes.
The authors determined whether diabetic patients with HCV virus treated with antiviral agents would improve diabetes, accounting for change in both HbA1c and diabetes medications, and whether any improvement was sustained. They recorded HbA1c and diabetes medications at 6-month intervals for 1.5 years pre- and post-treatment for 122 patients.
Patients were deemed to have improved diabetes if a reduction in HbA1c ≥0.5 percent was observed, with no increase in diabetes medications or a decrease in diabetes medications with a stable HbA1c.
“HCV infection is associated with an increased risk of diabetes, with improvement in glycaemic control after eradication,” the authors said.