Why Hepatitis C Patients Should Practice Diabetes Prevention
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If chronic Hepatitis C infection is resistant to treatment and escalates in severity, many serious health conditions can result. Referred to as end stage liver disease, this advanced level of illness is typically characterized by cirrhosis (the permanent hardening and shrinking of the liver), liver failure (where the liver can no longer function) or hepatocellular carcinoma (the most common kind of liver cancer). However, careful evaluation of the latest research indicates that diabetes mellitus is likely a crucial intermediate link between Hepatitis C and one of the grave outcomes of end stage liver disease.
The following three studies help clarify the relationship between Hepatitis C, diabetes mellitus and hepatocellular carcinoma:
- In light of the growing mass of evidence suggesting that diabetes mellitus could be to blame for the worsening of Hepatitis C infection, Dutch researchers aimed to determine the risk of liver cancer among those with both diabetes mellitus and advanced Hepatitis C. As published in the June 2008 edition of Hepatology, they found that for those with both chronic Hepatitis C and advanced cirrhosis, diabetes mellitus increased the risk of developing hepatocellular carcinoma.
- Along the same lines, findings published in the March 2009 edition of the journal Hepatology set out to quantify how a successful Hepatitis C treatment outcome translates into a diabetes mellitus diagnosis. Understood as the inability to detect any Hepatitis C virus genetic material six months after therapy ends, a sustained virological response is the current definition of a successful treatment outcome. Conducted by Japanese researchers from Toranomon Hospital in Tokyo, this study indicated that achieving a sustained virological response to Hepatitis C interferon treatment causes a two-thirds reduction in the risk of developing adult-onset diabetes mellitus.
- Published in the October 2010 edition of the American Journal of Medicine, the same Japanese team from Tokyo studied diabetes mellitus’ impact on the development of liver cancer in those treated for Hepatitis C with interferon therapy. The results of this study are particularly meaningful because it was relatively large and lengthy – with more than 2,000 participants followed for an average of 6.7 years. The key findings were as follows:
- The rates of liver cancer in diabetics were significantly higher than those of non-diabetics. Twelve years following interferon treatment, the rates for diabetics who developed hepatocellular carcinoma were 24.4 percent – compared to 5.6 percent in non-diabetics.
- In patients who achieved a sustained virologic response to interferon therapy, having diabetes had no significant effect on developing liver cancer.
- In patients who did not achieve a sustained virologic resonse to interferon therapy, significantly more diabetics than non-diabetics developed liver cancer.
The authors concluded that for those who are non-responders (did not achieve a sustained virologic response) to Hepatitis C treatment, diabetes mellitus greatly raises the risk of developing hepatocellular carcinoma.
The overall arching goal in all of these analyses is to determine the best strategy for preventing liver cancer. Hepatocellular carcinoma is a challenging diagnosis, frequently leading to fatality within a couple of years. Typical advice for preventing liver cancer involves vaccinating against Hepatitis A and B, promptly treating viral hepatitis and avoiding alcohol. However, the research described above clearly implies that preventing diabetes mellitus is another wise way to protect from hepatocellular carcinoma.
According to the American Diabetes Association, you can prevent or delay the development of adult onset diabetes through a healthy lifestyle. With practices such as improving diet, increasing physical activity level and maintaining a healthy weight, the risk of being diagnosed with diabetes mellitus will lessen. Although such lifestyle practices are beneficial to just about anyone desiring health, the research indicates that it is especially important for Hepatitis C interferon therapy non-responders – as this group of people appear to be at the highest risk for developing adult onset diabetes and, eventually, hepatocellular carcinoma.
References:
http://emedicine.medscape.com/article/282814-overview, Hepatic Carcinoma, Primary, Keith E. Stuart, MD, Retrieved October 14, 2010, Medscape, 2010.
http://www.diabetes.org/diabetes-basics/prevention/, Prevention, Retrieved October 14, 2010, American Diabetes Association, 2010.
http://www.hcvadvocate.org/hcsp/articles/rellosa.html, Hepatocellular Carcinoma, Retrieved October 14, 2010, Isabelita Cordoba-Rellosa, MD, Retrieved October 14, 2010, Hepatitis C Support Project, 2010.
http://www.medicalnewstoday.com/articles/153591.php, What Is The Relationship Between Hepatocellular Carcinoma And Type 2 Diabetes Mellitus?, Retrieved October 12, 2010, MediLexicon International Ltd., 2010.
http://www.medscape.com/viewarticle/720925, Diabetes Is Leading Cause of Attributable Cases of Hepatocellular Carcinoma, Nick Mulcahy, Retrieved October 12, 2010, WebMD LLC, 2010.
http://www.ncbi.nlm.nih.gov/pubmed/18506898, Increased risk of hepatocellular carcinoma among patients with hepatitis C cirrhosis and diabetes mellitus, Veldt BJ, et al, Retrieved October 12, 2010, Hepatology, October 2008.
http://www.ncbi.nlm.nih.gov/pubmed/19127513, Sustained virological response reduces incidence of onset of type 2 diabetes in chronic hepatitis C, Arase Y, et al, Hepatology, March 2009.
http://www.ncbi.nlm.nih.gov/pubmed/20920698, Diabetes enhances hepatocarcinogenesis in noncirrhotic, interferon-treated hepatitis C patients, Kawamura Y, et al, The American Journal of Medicine, October 2010.
