I am often asked questions regarding what to eat when you have hepatitis C. Well, the answers are not always so simple. First, let’s talk about some complications of having hepatitis C regarding your blood sugar and related issues – diabetes.
Research shows that there is a higher prevalence of diabetes among persons infected with HCV. Chronic hepatitis C may contribute to the progression to diabetes. According to the American Dietetic Association, diabetes mellitus is defined as a metabolic disease characterized by hyperglycemia (high blood sugar) and associated with short- and long-term complications.
Diabetes mellitus has been reported to be more prevalent in patients with HCV compared to those with hepatitis B and those with other types of liver diseases. Fatty liver disease is also associated strongly with the development of type 2 diabetes.
Diabetes is a chronic endocrine disorder characterized by the inability to properly utilize sugar, specifically glucose, a simple carbohydrate. This results in excessively high glucose levels in the blood. Diabetes involves either relative or absolute shortage of insulin, a hormone that regulates the body’s breakdown of carbohydrates.
Type 2 diabetes, often called non-insulin dependent diabetes, is the most common form of diabetes. Type 2 diabetes affects 90% – 95% of the millions of people with diabetes.
People with type 2 diabetes produce insulin; however, the insulin their pancreas secretes is either not enough or the body is unable to recognize the insulin and use it properly. This is called insulin resistance. When there isn’t enough insulin or the insulin is not used, as it should be, glucose (sugar) can’t get into the body’s cells.
When glucose builds up in the blood instead of going into cells, the body’s cells are unable to properly function. Other problems associated with excess blood glucose include:
- Dehydration. Build up of blood glucose sugar in the blood can cause an increase in urination. The body is trying to clear the sugar from the body. When the kidneys lose the glucose through the urine, a large amount of water is also lost, which can cause dehydration.
- Diabetic coma. When a person with type 2 diabetes becomes severely dehydrated and is not able to drink enough fluids to make up for the fluid losses, they may develop this life-threatening complication called hyperosmolar nonketotic diabetic coma.
- Other Damage. Over time, the high blood glucose levels may damage the nerves and small blood vessels of the eyes, kidneys, and heart and predispose a person to hardening (atherosclerosis) of the large arteries that can cause heart attack and stroke.
A cross-sectional national survey in the US found that people with HCV were at least three times more likely to have type 2 diabetes than those without HCV. This survey controlled for other factors including age, BMI, economic status and substance use history. Other studies show that among people with hepatitis C with cirrhosis, increased diabetes risk is not correlated with cofactors such as age, gender, BMI, or genotype. This increased risk also is present in people with HCV without cirrhosis. This may be related to fatty liver and iron deposits in the liver (hemochromatosis), which are common in people with HCV infection.
Impaired glucose tolerance (IGT) along with insulin resistance and increased insulin (hyperinsulinemia) is common in people diagnosed with cirrhosis. IGT and hyperinsulinemia usually precedes development of type 2 diabetes mellitus in 10% to 20% of these persons.
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