Abrupt onset of diabetes during interferon-alpha therapy in patients with chronic hepatitis C


Dr I. Conget, Endocrinology and Diabetes Unit, Villarroel 170, 08036 Barcelona, Spain. E-mail: iconget@clinic.ub.es


Introduction Interferon-alpha (IFN-α) is now widely used in the treatment of chronic hepatitis C. Few patients have been reported as developing impaired glucose tolerance or diabetes mellitus (DM) using this therapy. The explanation for the development of DM in chronic hepatitis C treated with IFN-α is unclear. We report two patients who developed an abrupt onset of diabetes during IFN-α for chronic hepatitis C.

Case reports  Two male middle-aged patients were admitted to our hospital for an abrupt onset of diabetes, in diabetic ketoacidosis, with a very short duration of hyperglycaemic symptoms. Their clinical course was similar. Case 1 never demonstrated any markers of pancreatic immunogenicity. Case 2 had high levels of decarboxylase glutamic acid autoantibodies (GADAb), before the IFN-α treatment that persisted. We compared initial β-cell function and metabolic control with a group of middle-aged patients from our hospital who had recently been diagnosed with Type 1 diabetes mellitus (DM1). In contrast to these, the onset of the disease was particularly severe with β-cell function substantially impaired and displaying unstable short-term metabolic control.

Conclusions  Type 1 diabetes should be considered as a potential complication if IFN is administered to patients with chronic hepatitis C. Its onset may be severe and result in short-term difficulties in metabolic control.

Diabet. Med. 18, 764–767 (2001)