The Five: Diabetes —Alan Franciscus, Editor-in-Chief

If you notice, I did not title this article HCV and diabetes.  That is because new studies have not found a direct link between hepatitis C and diabetes—that is type 2 Diabetes mellitus.  However, it is still being studied, and it keeps coming up so the complete story may not be over.   Regardless, it is an important health issue facing people living with hepatitis C especially those who are considered part of the ‘Baby Boomer’ generation.  This month’s Five is about diabetes and how it relates to people with hepatitis C and why it is important to be tested for it, how to treat it and how it may improve the chances of being approved for HCV treatment. 

Diabetes affects approximately 40 million Americans. 

1. At-Risk Populations:  People who are more likely to develop diabetes include people 45 years old or older, being overweight or obese, having a parent, brother or sister with diabetes, having a genetic disposition to developing diabetes.  Certain races and ethnicities such as African Americans, Hispanics, Alaskan Natives, American Indians, Asian Americans, Native Hawaiians or Pacific Islanders are more prone to having diabetes.

2. Symptoms:  The most common symptoms of diabetes include increased thirst and hunger or appetite, dry mouth, frequent urination (peeing), fatigue (feeling tired), unexplained weight loss—even when eating more food.  In extreme cases, people may experience loss of consciousness.

3. Complications:  Over time, left untreated or uncontrolled diabetes can lead to very serious complications including mental confusion, blurred vision, sores or wounds that are slow to heal or don’t heal, sexual problems, heart and kidney disease, blindness, peripheral neuropathy, amputation, and death.

4. Treatment:  Diabetes can be treated and controlled with diet, exercise, and medications.  It is important to be monitored regularly.

5. HCV Treatment:  Many insurance companies and state Medicaid programs are restricting HCV treatment to those with severe fibrosis and cirrhosis.   There are other conditions that may increase the chances of being approved for HCV treatment—Type 2 Diabetes mellitus is one of the conditions that may increase the likelihood of being approved for treatment.  (See: AASLD-ISDA Recommendations for Testing, Managing, and Treating Hepatitis C 2014: When and in Whom to Initiate Treatment).  Talk to your medical provider to find out if you should be tested for diabetes.  If you have diabetes—check with you medical provider about HCV treatment.

The Bottom Line:  Diabetes is a serious disease that has many consequences.  The United States Preventive Services Task Force (USPSTF) now recommends testing adults for diabetes who have high blood pressure (greater than 135/80 mm Hg).  The USPSTF is currently in the process of updating their guidelines to include screening adults:
“Having factors that increase the chances of developing high blood sugar or diabetes, such as being 45 or older, being overweight or obese, or having a close relative with diabetes.”
The updated guidelines should be released in the coming months.

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