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TOPIC: New-Onset Diabetes from Ledipasvir/Sofosbuvir

New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9025

Price Offline Elite Member Posts: 237 Thank you received: 343 Karma: -5	New-Onset Diabetes Mellitus With Exposure to Ledipasvir and Sofosbuvir. hic.sagepub.com/content/3/4/2324709615623300.full
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9044

Enkel
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Anyone on the forum have measured the glucose during treatment?

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9045

LondonGirl
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Hi Enkel, No, but have always said, that while on tx, it makes sense to me to keep an eye on general observations, the more the better.

This report was only 2 patients from what I understand? one co-infected with HIV and the other obese,
Is there an easy test for Diabetes / Pre diabetes, or is it blood test only?

GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9046

Enkel
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The old therapy induces diabetes too

www.ncbi.nlm.nih.gov/pmc/articles/PMC3161293/

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9048

DrJames
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If you look at what the CDC has to say about it

www.cdc.gov/diabetes/statistics/incidence/fig3.htm

You will note that people in the 45-65 age range have an annual incidence of 12 per thousand. That is 3 per thousand per 3 months.

So all other things being equal 1:300 patients aged 45-65 who are on ANY 3 month treatment will develop diabetes.

This is not to say insulin resistance and HCV are not related, simply that STUFF, as in all sorts of stuff happens to patients on and off treatment.

YMMV

Last Edit: 2 years 4 months ago by DrJames.

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9049

LondonGirl
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mYes, was about to say, Diabetes is quite common with those with HCV and those over 50.

Keep a healthy diet, have a check here & there, get rid of HepC !

GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

Last Edit: 2 years 4 months ago by LondonGirl.

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9050

DrJames Offline Platinum Member Posts: 1561 Thank you received: 5922 Karma: 92	Having HCV substantially increase your risk of developing Diabetes... www.ncbi.nlm.nih.gov/pmc/articles/PMC2669937/#!po=1.08696 Among those at high risk for T2D, persons with HCV infection were more than 11 times as likely as those without HCV infection to develop T2D (relative hazard, 11.58; 95% CI: 1.39-96.6)
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9055

Price Offline Elite Member Posts: 237 Thank you received: 343 Karma: -5	London girl: According to the American Diabetes Association, a fasting blood sugar above 100 gives you a diagnosis of pre diabetes, which means you're insulin resistant. A HOMA obtained with a formula that uses blood sugar and insulin levels can also tell you if you're insulin resistant. P.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9056

Price
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The study says the ION-3 clinical trial showed that in those who received ledipasvir/sofosbuvir for 12 weeks, the hyperglycemia rates were.....
grade 1: serum glucose > up to 160 mg/dL......33.3%
grade 2: >160-250 mg/dL....11.6%
grade 3: >250-500 mg/dL .....2.3%
grade 4: >500 mg/dL
Those who received the medication for 8 weeks had hyperglycemia at the following rates: 21.4% (grade 1), 7.9% (grade 2), and 1.4% (grade 3).
All patients with Grade 3 or 4 increased serum glucose had either a medical history of diabetes or glucose intolerance (HbA1c > 6.0%) at screening

That's worse than interferon.

P

Last Edit: 2 years 4 months ago by Price.

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9057

Enkel Offline Platinum Member Posts: 329 Thank you received: 165 Karma: 0	Price, Can you post the link?
	Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety. Started Twinvir 12/12/15. Two weeks ALT 17 at 2 weeks Viral Load UND at 2 weeks ALT 13.5 at 7 weeks EOT ALT 10.5 at 15 weeks EOT ALT 13 at 27 weeks EOT, VL UND, Cured The administrator has disabled public write access.

New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9058

Enkel
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Price you should add this:

All patients with Grade 3 or 4 increased serum glucose had either a medical history of diabetes or glucose intolerance (HbA1c > 6.0%) at screening

Male, Fibro F1. Geno 1b. ALT 67 before treatment Viral load 5 million. My huge viral load replicates in my nervous system as I suffer anxiety.
Started Twinvir 12/12/15.
Two weeks
ALT 17 at 2 weeks
Viral Load UND at 2 weeks
ALT 13.5 at 7 weeks EOT
ALT 10.5 at 15 weeks EOT
ALT 13 at 27 weeks EOT, VL UND, Cured

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9061

kenbasman Offline Elite Member Posts: 164 Thank you received: 239 Karma: 0	I have type II diabetes and my sugars have been extra low during tx. Suffering more from hypo than hyperglycemia. I take no meds for the diabetes. I just control it with diet and exercise. I check my bloods a fair bit. I just figured that the diabetes was being at least partially caused by my liver, not my pancreas, and the low numbers were a result of tx. Hmmmm.
	HCV 35 yrs G1a F3 Tx naive started Lesovir-C 15/12/2015 pre tx: VL 5,250,000 ALT 374 AST 208 FIBROSCORE 10.4 4 weeks tx ALT 29/ AST 33. VL < 12 UI/mL 8 weeks tx ALT 29/ AST 34. VL UND 4 weeks after tx UND. SVR4. ALT 24/AST 18 The administrator has disabled public write access.

New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9063

LondonGirl
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Hmmm
So, 'serum glucose' is what it looks like on the blood test?
I don't think I've ever had one of those tests.
May be worth keeping an eye on the GP will run a test. Why not?

I have read that some patients were pre-diabetes before treating and then after SVR it went away.
I guess we just have to do careful watching for a few things, an unwell liver can cause a lot of problems.

Enkel said "All patients with Grade 3 or 4 increased serum glucose had either a medical history of diabetes or glucose intolerance (HbA1c > 6.0%) at screenin" - Ahhh thanks Enkel, thought those figures rather high!

GT1a Dec14 F2/8.7 VL 900000-2.5M
Jan16 Hepcivir-L MonkMed/Redemption
Baseline: VL 913575 Alt 76 Platelets low
Wk2 VL1157 Alt 23
DET Wk 8 VL 32 Alt19 'In the slow lane'
June16 Fibro 5.7 F0/1 LIF 1.5
Wk 11 VL<12 Alt 13 Det/Unq
Extending tx 12 wks Mylan Sofo/Dac MonkMed
Wk 14 VL <12 Det/Unq
Wk 16 VL UNDETECTED
Wk 22 + 4 Wks Sunprevir FixHepC
Wk 24 UNDETECTED Alt 13
Wk 12 post tx SVR12 Wk 26 SVR24
Thank-you Tim, Dr Debasis @ MonkMed & Dr Freeman @ Fix HepC

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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9068

Price Offline Elite Member Posts: 237 Thank you received: 343 Karma: -5	That's because HCV causes diabetes. I preached about insulin resistance for years, www.projectsinknowledge.com/cc3/index2.cfm?id=243 so ban me now or I'll drive you crazy talking about IR. I'm thinking the Zolpidem on your cheat sheet can cause hyperglycemia. P.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 2 years 4 months ago #9072

Price Offline Elite Member Posts: 237 Thank you received: 343 Karma: -5	It's a big can of worms. You won't be able to take meds that increase blood sugar and there are many that do. Plus having high blood sugar predisposes you to getting infections. And nobody will like me again because I'll tell them not to eat chocolate and ice cream P.
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