• Fawad Qureshi
  • Faisal Qureshi
  • Qudsia Anjum Fasih
  • Sarwar Zuberi


Various epidemiological studies have suggested that hepatitis C virus (HCV) infection is a risk factor for the development of diabetes mellitus (DM) type 2.1-6 The etiological factors were initially thought to be cirrhosis but further studies differentiating between HCV and hepatitis B virus (HBV) related infection have shown that patient with HCV infection have a higher prevalence of Diabetes mellitus type-2.7A retrospective analysis of 1117 patients with chronic viral hepatitis found that diabetes was present in significantly more patients with hepatitis C compared to hepatitis B virus (HBV) infection (21 versus 12 percent).2 HCV genotype 2a was over represented among the diabetic patients. In another case control trial, the prevalence of HCV infection was significantly higher among patients with diabe-tes mellitus compared to controls (4.2 versus 1.6 percent). Patients undergoing liver transplantation for HCV also appear to be at increased risk for developing diabetes mellitus following transplantation 8.The cause of these associations is unknown, but their magnitude may be overestimated based upon the retrospective nature of the reports and due to some of the following factors.9a.        Patients with diabetes have more parenteral exposures than the general population, placing them at increased risk for transmission of viruses.b.       HCV infection becomes chronic more often than HBV infection.c.        Not all studies are controlled for the presence of cirrhosis, which may be associated with impaired glucose tolerance.Only one study that we came across which was from Saudi Arabia had mentioned other variables and showed that Anti-HCV-positive type-2 diabetics, when compared to non-diabetics, had a higher Body mass index (BMI), a frequent family history of DM, elevated serum transaminases, thrombocytopenia, and liver cirrhosis on biopsy.10 With this hypothesis in mind, we conducted the present study to determine other variables such as familial inheritance as the cause of higher frequency of DM type 2 among patients with HCV infection.


Mehta SH, Brancati FL, Strathdee SA, Pankow JS, Netski D, Coresh J, et al. Hepatitis C virus infection and incident type 2 diabetes. Hepatology 2003;38:50-6.

Mason AL, Lau JY, Hoang N, Qian K, Alexander GJ, Xu L, et al. Association of diabetes mellitus and chronic hepatitis C virus infection. Hepatology 1999;29:328-33.

Simo R, Hernandez C, Genesca J, Jardi R, Mesa J. High prevalence of hepatitis C virus infection in diabetic patients. Diabetes Care 1996;19:998-1000.

Caronia S, Taylor K, Pagliaro L, Carr C, Palazzo U, Petrik J, et al. Further evidence for an association between non-insulin-dependent diabetes mellitus and chronic hepatitis C virus infection. Hepatology 1999;30:1059-63.

Okan V, Araz M, Aktaran S, Karsligil T, Meram I, Bayraktaroglu Z, et al. Increased frequency of HCV but not HBV infection in type 2 diabetic patients in Turkey. Int J Clin Pract 2002;56:175-7.

Mehta SH, Brancati FL, Sulkowski MS, Strathdee SA, Szklo M, Thomas DL. Prevalence of type 2 diabetes mellitus among persons with hepatitis C virus infection in the United States. Ann Intern Med 2000;133:592-99.

Fraser GM, Harman I, Meller N, Niv Y, Porath A. Diabetes mellitus is associated with chronic hepatitis C but not chronic hepatitis B virus infection. Isr J Med Sci 1996;32:526.

Bigam DL, Pennington JJ, Carpentier A, Wanless IR, Hemming AW, Croxford R et al. Hepatitis C-related cirrhosis: A predictor of diabetes after liver transplantation. Hepatology 2000;32:87-90.

Hadziyannis S, Karamanos B. Diabetes mellitus and chronic hepatitis C virus infection (editorial). Hepatology 1999; 29:604-5.

Akbar DH, Siddique AM, Ahmed MM. Prevalence of Type-2 diabetes in patients with hepatitis C and B virus infection in Jeddah, Saudi Arabia. Med Princ Pract 2002;11:82-5.