Paul, while my husband was taking Harvoni and even after he finished his treatment, his glucose levels always fluctuated from very low to very high. His Doctor never made an issue of it.
When he met with a nutritionist she suggested that since the level was a little high, he may be pre-diabetic.
I took it upon myself and requested from his PC doctor a script to check his A1C level. The test came back with a 5.4 level
Don't worry, it's all due to the treatment and eventually it will go back to normal.
Mena
mallani said
Dec 16, 2015
Hi Paul,
Congrats on your SVR. We have discussed the relationship between Chronic HCV and diabetes many times. It's probably a good thing to revisit.
All HCV patients should be routinely monitored for Type-2 diabetes. In fact, the association is so strong, that all new diabetic patients are now routinely tested for HCV. Various studies have shown that between 30 and 70% of HCV patients have impaired glucose metabolism. This is usually due to Insulin Resistance (IR). Blood glucose levels are synergistically controlled by two hormones, insulin and glucagon, that are secreted by the beta and alpha cells in the Islets of Langerhans (in the pancreas). Insulin removes glucose from the blood and stores it as glycogen in the liver, whereas glucagon does the opposite.
It has now been proved that HCV causes IR by virtue of an element of it's core protein interfering with the complex intracellular insulin signalling pathway. The core proteins of Genotypes 3a and 1b are more likely to cause this. The results are higher than normal insulin levels (it may be ineffective insulin), that fails to adequately control the blood glucose. IR causes fatty liver, increased liver fibrosis and can even provoke HCC development. Essentially, Type 2 Diabetes is due to IR in most cases. This type of diabetes develops slowly and should be suspected in any patient with more than one fasting plasma glucose of >7.0 mmol/l.
For 15 years, I convinced myself I was not diabetic, by going on a low glucose diet for a few days before my blood test. Now, we have the Hb A1c test. This measures the amount of glucose attached to haemoglobin as glycated Haemoglobin in RBCs. The level of glycated Hb directly corresponds to the level of glucose in plasma. As RBC's live for 8-12 weeks, this test gives the equivalent of an average blood glucose for 8-12 weeks. A normal HbA1c is <42 mmol/mol, usually expressed as a percentage i.e. <6%. A diabetic HbA1c is >6.5%.
My HbA1c was 7% 6 months ago. After watching my GI food intake, this has dropped to 6.8%. As a general rule, doctors don't start drug treatment (eg with Metformin) unless the HbA1c is above 7%.
Another important fact is that IR can completely disappear after SVR. Unfortunately, mine hasn't.
Just something else to watch. Cheers.
Matt Chris said
Dec 14, 2015
Hey paulie
Great news about your latest status and on Hep-C and diabetes.
Your post is the kind of input that gives great evidence and encouragement for all those considering treatment via the new DAA's to make there own health have a major improvement.
matt
dharmabum said
Dec 14, 2015
Hi Paulie,
I too have finished a 12 week course of Harvoni and eight months later, I am still UND. During treatment I saw a disturbing rise in my blood glucose levels, which continued for a year and then suddenly disappeared; poof. It was confusing to me because there exists no family history of diabetes on either side and I watch my sugar and carbs carefully. Must have been my old friend Hep C saying goodbye.
You are so right, it feels amazing to cross these two concerns off the list. Blood pressure, not so much, but it is very controllable with meds, diet and exercise. I feel very thankful and lucky today.
Happy Holidays all,
Joann
Greg D said
Dec 14, 2015
Hi Paul,
I also have always wondered about the relationship between hep c and diabetes. Also throughout my life I have always had blood pressure on the low side of normal. Lately, however, I have been checking it from time to time and since svr my bp is now on the high side of normal. With regards to my diet controlled diabetes, my glucose tests in the past have really fluctuated while I had hep c and while on treatment. In post treatment I am hoping my glucose levels will come down on their own (would probably happen very slowly?) Is this unrealistic, I'm not sure...but focusing on hep c, from what I have read there is a relationship between liver function and blood sugars. If Mallani could, I would be very interested to hear his thoughts, or any comments from others as well of course.
The testers that use strips I have found to be unreliable and have stopped testing with those. Testing every three months at a lab instead. Not sure how trends will go but hoping for a steady noticeable decline as time passes.
Really hoping I am not a total fool by my approach, however I probably am by risking my kidney health in 'hope and speculation'.
Greg
Tig said
Dec 14, 2015
Hi Paul,
Welcome back! I'm happy to hear you have continued your SVR status and been blessed to beat another dreaded disease, Diabetes. I had issues with higher than normal blood glucose levels and following SVR, they dropped as well. I agree that HCV impacts many facets of our life and attention to details like this are important. I'm sure you're feeling a good bit of relief after achieving these health goals and rightly so!
Thanks for the advice and congratulations on all of your great health accomplishments! You've got lots of healthy living ahead!
pauliep said
Dec 14, 2015
Hi All- I haven't posted in a while, but it is now 7 months since finishing treatment with Harvoni and I am still Hep-c free. I wanted to bring up the topic of Type 2 diabetes as it relates to hep-c. About 5 years ago I was diagnosed with sustained high blood glucose which is also called adult onset type 2 diabetes. My physician and I were totally confused about this as I have no known family history of diabetes, I am not obese, and my eating and lifestyle habits are way outside of the profile for typical diabetics. I was put on a regimen of Metformin and lower than my already normal low carb diet. I was already on a medication for high blood pressure, so I began to get very anxious about my overall health. I had hep-c, high blood pressure, and diabetes. At 58 years old, I did not like my health outlook. A few years back I happened by chance while researching hep-c, to come across some information regarding a link between hep-c and diabetes. I have since learned that there is a lot of information available on this topic, but for some reason, doctors either aren't aware of it, or it is outside of their normal protocols, so they pretend not to know. I had all of the evidence that I needed and once I had my SVR, I decided to stop taking Metformin for blood sugar control. I had a physical last week and my blood glucose levels are normal. I think this is really important for the hep-c community to know. Keep track of your blood glucose levels with your routine hep-c monitoring and press your gastroenterologist to look into the connection between these 2 diseases. I now, at 63 years old can remove 2 very serious health issues from the ever growing list of concerns; hep-c gone. Type 2 diabetes, gone. I would love to hear about anybody else's experience regarding hep-c and diabetes.
Paul, while my husband was taking Harvoni and even after he finished his treatment, his glucose levels always fluctuated from very low to very high. His Doctor never made an issue of it.
When he met with a nutritionist she suggested that since the level was a little high, he may be pre-diabetic.
I took it upon myself and requested from his PC doctor a script to check his A1C level. The test came back with a 5.4 level
Don't worry, it's all due to the treatment and eventually it will go back to normal.
Mena
Hi Paul,
Congrats on your SVR. We have discussed the relationship between Chronic HCV and diabetes many times. It's probably a good thing to revisit.
All HCV patients should be routinely monitored for Type-2 diabetes. In fact, the association is so strong, that all new diabetic patients are now routinely tested for HCV. Various studies have shown that between 30 and 70% of HCV patients have impaired glucose metabolism. This is usually due to Insulin Resistance (IR). Blood glucose levels are synergistically controlled by two hormones, insulin and glucagon, that are secreted by the beta and alpha cells in the Islets of Langerhans (in the pancreas). Insulin removes glucose from the blood and stores it as glycogen in the liver, whereas glucagon does the opposite.
It has now been proved that HCV causes IR by virtue of an element of it's core protein interfering with the complex intracellular insulin signalling pathway. The core proteins of Genotypes 3a and 1b are more likely to cause this. The results are higher than normal insulin levels (it may be ineffective insulin), that fails to adequately control the blood glucose. IR causes fatty liver, increased liver fibrosis and can even provoke HCC development. Essentially, Type 2 Diabetes is due to IR in most cases. This type of diabetes develops slowly and should be suspected in any patient with more than one fasting plasma glucose of >7.0 mmol/l.
For 15 years, I convinced myself I was not diabetic, by going on a low glucose diet for a few days before my blood test. Now, we have the Hb A1c test. This measures the amount of glucose attached to haemoglobin as glycated Haemoglobin in RBCs. The level of glycated Hb directly corresponds to the level of glucose in plasma. As RBC's live for 8-12 weeks, this test gives the equivalent of an average blood glucose for 8-12 weeks. A normal HbA1c is <42 mmol/mol, usually expressed as a percentage i.e. <6%. A diabetic HbA1c is >6.5%.
My HbA1c was 7% 6 months ago. After watching my GI food intake, this has dropped to 6.8%. As a general rule, doctors don't start drug treatment (eg with Metformin) unless the HbA1c is above 7%.
Another important fact is that IR can completely disappear after SVR. Unfortunately, mine hasn't.
Just something else to watch. Cheers.
Hey paulie
Great news about your latest status and on Hep-C and diabetes.
Your post is the kind of input that gives great evidence and encouragement for all those considering treatment via the new DAA's to make there own health have a major improvement.
matt
Hi Paulie,
I too have finished a 12 week course of Harvoni and eight months later, I am still UND. During treatment I saw a disturbing rise in my blood glucose levels, which continued for a year and then suddenly disappeared; poof. It was confusing to me because there exists no family history of diabetes on either side and I watch my sugar and carbs carefully. Must have been my old friend Hep C saying goodbye.
You are so right, it feels amazing to cross these two concerns off the list. Blood pressure, not so much, but it is very controllable with meds, diet and exercise. I feel very thankful and lucky today.
Happy Holidays all,
Joann
Hi Paul,
I also have always wondered about the relationship between hep c and diabetes. Also throughout my life I have always had blood pressure on the low side of normal. Lately, however, I have been checking it from time to time and since svr my bp is now on the high side of normal. With regards to my diet controlled diabetes, my glucose tests in the past have really fluctuated while I had hep c and while on treatment. In post treatment I am hoping my glucose levels will come down on their own (would probably happen very slowly?) Is this unrealistic, I'm not sure...but focusing on hep c, from what I have read there is a relationship between liver function and blood sugars. If Mallani could, I would be very interested to hear his thoughts, or any comments from others as well of course.
The testers that use strips I have found to be unreliable and have stopped testing with those. Testing every three months at a lab instead. Not sure how trends will go but hoping for a steady noticeable decline as time passes.
Really hoping I am not a total fool by my approach, however I probably am by risking my kidney health in 'hope and speculation'.
Greg
Hi Paul,
Welcome back! I'm happy to hear you have continued your SVR status and been blessed to beat another dreaded disease, Diabetes. I had issues with higher than normal blood glucose levels and following SVR, they dropped as well. I agree that HCV impacts many facets of our life and attention to details like this are important. I'm sure you're feeling a good bit of relief after achieving these health goals and rightly so!
Thanks for the advice and congratulations on all of your great health accomplishments! You've got lots of healthy living ahead!
Hi All- I haven't posted in a while, but it is now 7 months since finishing treatment with Harvoni and I am still Hep-c free. I wanted to bring up the topic of Type 2 diabetes as it relates to hep-c. About 5 years ago I was diagnosed with sustained high blood glucose which is also called adult onset type 2 diabetes. My physician and I were totally confused about this as I have no known family history of diabetes, I am not obese, and my eating and lifestyle habits are way outside of the profile for typical diabetics. I was put on a regimen of Metformin and lower than my already normal low carb diet. I was already on a medication for high blood pressure, so I began to get very anxious about my overall health. I had hep-c, high blood pressure, and diabetes. At 58 years old, I did not like my health outlook. A few years back I happened by chance while researching hep-c, to come across some information regarding a link between hep-c and diabetes. I have since learned that there is a lot of information available on this topic, but for some reason, doctors either aren't aware of it, or it is outside of their normal protocols, so they pretend not to know. I had all of the evidence that I needed and once I had my SVR, I decided to stop taking Metformin for blood sugar control. I had a physical last week and my blood glucose levels are normal. I think this is really important for the hep-c community to know. Keep track of your blood glucose levels with your routine hep-c monitoring and press your gastroenterologist to look into the connection between these 2 diseases. I now, at 63 years old can remove 2 very serious health issues from the ever growing list of concerns; hep-c gone. Type 2 diabetes, gone. I would love to hear about anybody else's experience regarding hep-c and diabetes.