Hagag Rasha Youssef, Selim Ahmed Fawzy, Darrag Omneya Mohamed, Zied Hassan, Aboelnasr Mohamed Sabry
Department of internal medicine, Faculty of medicine, Tanta University, Tanta, Egypt.
Kafr-Elsheikh Liver Institute, Kafr-Elsheikh, Egypt.
Diabetes Metab Syndr Obes. 2022 Apr 26;15:1261-1268. doi: 10.2147/DMSO.S354023. eCollection 2022.
The aim of the present work was to investigate whether hepatitis C virus treatment by directly acting antivirals obligate shifting patients with type 2 diabetes from oral hypoglycemic drugs to insulin therapy.
This was a prospective study including 92 treatment-naïve patients with chronic hepatitis C virus infection and type 2 diabetes who were eligible for treatment with directly acting antivirals (sofosbuvir + daclatasvir ± ribavirin). Patients in the study were divided into two groups; group 1 included 22 patients on insulin therapy and group 2 included 70 patients on oral antidiabetic medications. Patients were advised to keep on their anti-diabetic treatment.
All our patients achieved sustained virologic response with significantly lower HbA 12 weeks after the end of therapy (p. values 0.001 for group 1 and group 2). There was no statistically significant difference in HbA level post-treatment between both groups (p. value 0.352).
Achievement of sustained virologic response using interferon free, directly acting antivirals-based regimen was associated with significantly lower HbA 12 weeks after the end of therapy. The type of treatment used for type 2 diabetes (oral drugs or insulin) did not affect improved glycemic control observed after achieving sustained virologic response.
本研究旨在调查使用直接作用抗病毒药物治疗丙型肝炎病毒是否必然会使2型糖尿病患者从口服降糖药转为胰岛素治疗。
这是一项前瞻性研究，纳入了92例初治的慢性丙型肝炎病毒感染合并2型糖尿病患者，这些患者有资格接受直接作用抗病毒药物（索磷布韦+达卡他韦±利巴韦林）治疗。研究中的患者分为两组；第1组包括22例接受胰岛素治疗的患者，第2组包括70例接受口服抗糖尿病药物治疗的患者。建议患者继续进行抗糖尿病治疗。
所有患者均实现了持续病毒学应答，治疗结束12周后糖化血红蛋白显著降低（第1组和第2组的p值均为0.001）。两组治疗后糖化血红蛋白水平无统计学显著差异（p值为0.352）。
使用不含干扰素、基于直接作用抗病毒药物的方案实现持续病毒学应答与治疗结束12周后糖化血红蛋白显著降低相关。用于2型糖尿病的治疗类型（口服药物或胰岛素）并不影响在实现持续病毒学应答后观察到的血糖控制改善情况。
