Prevalence of Diabetes in Patients with HCV Hepatitis and Cirrhosis

Objective: To determine the frequency of Diabetes Mellitus in patients, suffering with chronic Hepatitis C virus infection and cirrhosis. Study design: Case Control study. Place and Duration: This study was conducted from Jan 2012 to Dec 2012 at POF hospital Wah Cantonment. Methodology: It was a case control study and was conducted in the department of medicine, Pakistan Ordinance Factories Hospital and Wah medical college, Wah Cantonment. Those individuals who were having evidence of chronic hepatitis C infection in the form of positive ELISA, positive PCR for HCV RNA with raised Serum ALT and/or clinical/sonographic evidence of cirrhosis were assessed for presence of Diabetes Mellitus according to WHO criteria. A proforma was filled which was approved by hospital ethical committee. Results: A total of 268 subjects were included with evidence of Hepatitis C. Males were 56% (n: 150) and 44% (n: 118) were females. Male to female ratio was 1.2:1. Diabetes Mellitus was found in 19.4% (n: 52). Nineteen percent (n: 28) of the males and 20% (n: 24) of females had Diabetes Mellitus and their male to female ratio was 1: 1.86. Maximum number of cases (35% -18 cases) were in age group 51-55 years. Mean age of the patients having diabetes mellitus was 50.42 +/- 2SD years. None of diabetic patient was below 35 years. Seven diabetic (13%) patients were Insulin dependent and rest of the patients were either on dietary control or oral hypoglycemic agents. Serum ALT level varied from 52 IU/dl to 166 IU/dl. Viral genotype was carried out in 40% (n: 107) patients. It was genotype 3 in 90 % (n: 96) and genotype 2 in 10 % (n: 11). Evidence of cirrhosis on clinical or ultrasound assessment was found in 19% (n: 51). Healthy blood donors were taken as control group. The age groups did not match properly. Only 4% (n: 11) were having evidence of Hepatitis C. Only 3% (n: 01) of blood donors were diabetic compared to 20% in HCV positive individuals who had evidence of hepatitis. Conclusion: The prevalence of Diabetes Mellitus in patients with Chronic Hepatitis C infection is higher than in the general population. This figure is more than the age matched healthy blood donors with Hepatitis C, highlighting the fact that the mere presence of Hepatitis C virus is not enough to produce the disease but it is the presence of Chronic Hepatitis C which is essential. There is a need to study the general population so that exact nationwide figures of this association could be ascertained.

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