Prevalence of Diabetes Mellitus Type-2 among HCV Patients Admitted to The Virology Unit at Fever Hospital in Ismailia and Assessment of The Credibility of HBA1C in Assessing Diabetic Control among Diabetic Patients
Authors: Ibrahim Mohamed Khaled Mohamed , Elsayed Sara , Mostafa Nashwa , Ahmed Aya , Abdelrehem Khadiga Ahmed , Mahmoud Afnan , Leil Yasser , Adel Alzahraa Mohamed , Elsayed Abdelrahman , Abdelgawad Ahmed , Mohamed Mayar , El-bally AbdAllah 
Published: September 2022

Background

Glucose is the main source of energy for the human body. The liver plays an important role in physiological glycemic control as it produces, stores & release glucose depending on our need for glucose through involvement in several glucose metabolism processes including glycogenesis & glycolysis.After meal, carbohydrates in the food we eat are reduced into simplest form, glucose. Excess glucose removed from body and converted into glycogen in a process called glycogenesis.

Many studies approved that type 2 diabetes and hepatogenous diabetes are associated with increased risk of complication of chronic liver diseases and mortalityGenetic factors play a major role as well. HCV is considered a diabetogenic agent through multiple mechanisms: autoimmune phenomena, direct cytotoxic effect on pancreatic cells, and, blockage of insulin receptors at cellular levels. Alcoholic chronic liver disease affect both hepatocytes and pancreatic islet cells. Diagnosis of hepatogenous diabetes may be difficult as clinical manifestation in early stages of chronic liver disease may be absent and fasting plasma glucose may be normal.So in our study we want to identify best investigation to assess diabetes in chronic liver disease patients. Three prospective studies were collected assessing impact of diabetes among chronic liver disease patients; mainly the outcome, and all of them demonstrate lower 5-year cumulative survival

Aim

To provide data to augment the standard of care in diabetic patients with chronic liver disease..

Methods

Through a formal permission and access to the (VF-IFH) data and recording system.Data are recorded in a paper-based database system. Collection of data will be via copying the data into an excel sheet. Diabetic status; fasting glucose will be used as a gold standard to divide patients into diabetics (abnormal fasting glucose) and non-diabetics (normal fasting glucose level). Assessment of HbA1C values and patients’ diabetic control, as documented in (VF-IFH) database the sample size for this study is 167 of chronic hepatitis C patients

Results

The sample size for this study is 167 of chronic hepatitis C patients. Out of 167 questioned patients, 30.54% are diabetics. 25.5% of diabetic patients have normal HA1C (controlled) & 74.5% have abnormal HA1C (uncontrolled). 78.43% of patient have elevated fasting plasma glucose & about 21.57% have normal values.About 56.86% of hepatitis C patients that have diabetes, have abnormal kidney function (elevated serum creatinine).

Conclusion

Chronic liver disease affects glucose metabolism, ranging from mere glucose intolerance to overt diabetes, which is known as hepatogenous diabetes.We find that, about 50, 54% of chronic hepatitis C patients are diabetics with 25, 5% have normal HA1C, 74, 5% have abnormal levels. With no limitations, results precisely answer our question, demonstrate that hepatogenous diabetes is a common problem among chronic liver patients and HA1C is not a standard assessment tool for diabetes.Finally, we wait more researches to explain the pathological basis of the mysterious relation between cirrhosis and HA1C.