What You Need to Know About Hepatitis and Diabetes

Written by Ilene Raymond Rush

 

Hepatits B (HBV) and hepatitis C (HCV) are caused by viruses and are the two most common types of hepatits. Both HBV and HBC can lead to serious, long-term illness. Learn more:  

Hepatitis C

According to the Viral Hepatitis Action Coalition, 3.2 million Americans currently live with an active, chronic hepatitis C virus, a disease that damages the liver. The World Health Organization (WHO), reports that 700,000 people die each year from hepatitis C-related liver diseases. Among people with diabetes, hepatitis C (HCV) is the most common form of hepatitis. 

How HCV is spread: HCV is spread through exposure to infected blood. This can occur through the sharing of diabetes pens, syringes and lancets. Other causes include sharing needles used for intravenous drug use, unprotected sex, accidental contact with blood or blood transfusions from someone infected with the virus. During childbirth, babies can contract the virus from an infected mother.

How to prevent HCV: To prevent HCV the best route is to not share diabetes care pens or needles and to use protection during sex.

Symptoms: HCV often presents few symptoms in the early stages, when it may not require treatment. But over time, it can develop into a chronic illness, which can eventually lead to liver failure or liver cancer. Patients with late-stage HCV often require liver transplants, which do not always rid the body of the toxic virus.

Why HCV is connected with diabetes. Over time, chronic HCV prevents the liver from disposing of excess glucose. This results in hyperglycemia, or high blood sugar and can lead to insulin resistance, where the liver and muscles are unable to absorb glucose (sugar) for energy. Prolonged insulin resistance is also linked to type 2 diabetes.

Conversely, type 2 diabetes may decrease the liver’s ability to fight off infections such as HCV. In patients with pre-existing diabetes, the liver may already be damaged from storing excess glucose. The American Diabetes Association (ADA) reports that 80% of people with diabetes store too much glucose in their livers. The upshot is that the organ may become swollen or inflamed.

Having type 2 diabetes with HCV is also associated with a faster progression of HCV. 

Treatments:  Antiviral drugs have made inroads in clearing HCV infections from some patients. However, there are some major drawbacks to using these antivirals. The medications are expensive and side effects—including liver failure—can be serious. A January 2017 report issued by the Institute for Safe Medication Practices, a nonprofit that studies drug safety, scrutinized data from doctors worldwide citing this adverse event, among others. Experts including Robert S. Brown, MD, director of the Center for Liver Disease and Transplantation at NewYork-Presbyterian Hospital, told the New York Times that the new drugs should be further investigated.

In the meantime, experts have stressed the importance of doctors thoroughly testing a patient’s liver function before prescribing these new drugs as liver disease can be deceptive. (Patients with compromised liver function are not candidates for these drugs.)

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Hepatitis B 

How Hepatitis B (HBV) is spread: HBV is spread through bodily fluids. It can occur when people share diabetes supplies such as syringes, insulin pens, or spring-loaded lancets. It can also be transmitted through unprotected sex. A baby can contract the virus from an infected mother during childbirth.

Symptoms: HBV can start with an acute infection. While some people can fight the virus and clear the infection on their own (typcially within six months), others develop a chronic illness that can cause cirrhosis, or serious scarring, to the liver.

How to prevent HBV: The best route is to not share diabetes care pens or needles and to get the HBV vaccination.

The Centers for Disease Control and Prevention (CDC) recommends Hepatitis B vaccinations for all adults with diabetes who are under the age of 60. The vaccination is delivered as a series of three shots over a period of six months. For patients over 60, the CDC recommends consulting with your doctor.

Treatments: If you've been diagnosed with chronic hepatitis B there are some treatments including medications. In cases where the liver has been severely damaged, a liver transplant may be an option. 

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