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TOPIC: New-Onset Diabetes from Ledipasvir/Sofosbuvir

New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9073

  • Tommy
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I agree what you said about hep c and IR etc. That study you linked to said those medications are not well known to occur with its use. Only 2 cases out of God knows how many present 2 cases of new-onset diabetes. Also, one of them was black and had hep c and HIV. He was also on HIV drugs at the same time.
The 2nd patient was OBESE and black. Reason why I mention race is black people have a high rate of diabetes.
That was in 2014 and of course they mention more studies are needed.
Genotype 1A
ALT 473
AST 226
Virus Load 3,119,030
Results as of May-2016
5 week viral load/undetected as of 12/02/2016
Liver Biopsy Results from Feb 2013
Portal/Periportal chronic inflammation and mild interface hepatitis (Grade 2)
Focal Lobular chronic inflammation (Grade 1)
Portal/Periportal fibrosis (stage 1-2 trichrome and reticulin stains utilized)
Negative Iron stains.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9076

  • splitdog
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Price, can sugar intake cause diabetes?
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Genotype 3
VL 4,100,000
ALT 101 AST 71
Treatment Naive
Started Sof/Dac Jan 12, 2016
VL= <15 4 weeks in. AST/ALT normal.
VL=UNDETECTED 8 weeks in.
SVR4= Virus back. 3,300,000

Started generic Epclusa Sep. 23, 2017

4 weeks in <15 *Detected.
12 weeks in <15 *Not Detected.
16 weeks in <15 *Not Detected.
Finished 24 weeks treatment 3-17-18
SVR5 <15 Not Detected.
SVR 20 <15 Not Detected.
SVR 44 <15 Not Detected.

Thank you Jesus.
Thank you Dr. James
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9079

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This is interesting.
I have had Multiple Biochem Analysis tests in 2014 and 2015.
Specimen: Serum
My Clinical Notes state impaired sugar with my GP saying that I had a pre diabetic condition, something I have been trying to ignore until now. My 8 wk bloods are due soon and so I am wondering if I should include another sugar test request. I truly just want everything to just go away (hepc going I do believe) a completely self indulgent thought I know.
gt 1a VL 6m
F2/3 FibroScan - 9KPa in 2011 and 7KPa in 2015
sof/dac 10 December for 12 weeks
pre tx alt 85 ast 51
4 wk alt 34 ast 31 UND <35
8 wk alt 29 ast 32 UND <15
12wk alt 25 ast 25 EOT 3.3.16
SVR24 UND KPa5.3 F0 in normal range
I am well
.forever grateful to fixhepc
Last Edit: 5 years 10 months ago by pat1.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9081

  • Tommy
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splitdog wrote:
Price, can sugar intake cause diabetes?

No. Complete myth. That goes for type 1 and 2. Type 1 is genetic and other unknown factors.
Genotype 1A
ALT 473
AST 226
Virus Load 3,119,030
Results as of May-2016
5 week viral load/undetected as of 12/02/2016
Liver Biopsy Results from Feb 2013
Portal/Periportal chronic inflammation and mild interface hepatitis (Grade 2)
Focal Lobular chronic inflammation (Grade 1)
Portal/Periportal fibrosis (stage 1-2 trichrome and reticulin stains utilized)
Negative Iron stains.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9090

  • Price
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Tommy:

It's hard to diagnose hyperglycemia when blood sugar is not being checked.

Plus it says that in one of the studies a total of 47.2% had high blood sugar and considering that a fasting blood sugar of 123 (on two occasions) is considered diabetes, then the meds caused diabetes.

I would love to ask the authors a few questions, like how many of them were diabetics to begin with and were the people who failed treatment diabetics or insulin resistant. I bet they were.
Last Edit: 5 years 10 months ago by Price.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9092

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Splitdog:
No. Most of the food we eat turns into sugar. But if you eat lots of sugar then you'll increase the fat and fat cells are insensitive to insulin.

P
Last Edit: 5 years 10 months ago by Price.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9165

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Well I got all curious yesterday and pricked my fingers to check my sugars about 10 times. I am almost 6 weeks into tx with diabetes type II. No meds, just diet and exercise. I was +/- 80 (4.4 for those with the other measurement system) all day long and this morning before eating.
I don't know what that is worth as far as this thread goes, but I figured I contribute the info anyways...
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
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9185

  • Price
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Ken:
Did you check before or after meals? Please give exact numbers? Did you check at bedtime?

Thanks for doing this. This info will really help us figure out what happens to blood sugar during treatment and what can be done about it.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9187

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I checked this morning before eating and yesterday before eating and 2 hours after eating. My sugars never varied from 80 to 90, except that today, after exercise which was after breakfast, it went down to 64. This kind of hipoglycemia is kind of typical for me. I generally eat a tablespoon of honey before I exercise and today I didn't. My bad.
Only really specific thing I can say is that for me, my sugars have been lower since I started tx. I REALLY watch my diet and count carbs like an obsession. I even had some extra carbs before bed (a big granola bar with 20 grams of carbs) to see if my morning reading would be affected. It was nice and low in the morning (80).
If you have a specific way you think I should check my sugars for the good of this group discussion I will happily turn my fingers into pin cushions for a few days. just let me know what times of the day you would like to see.
Cheers,
Ken
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
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9282

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Ken:

I think you nailed it. This is very good news.

P.
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9287

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Great! Today is the same so far. So is every day, unless I decide to pig out on carbs, then the whole game changes...
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
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9294

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kenbasman wrote:
.......unless I decide to pig out on carbs, then the whole game changes...

Hmmm, and a commonly discussed side from Tx with these DAAs seems to be an increased appetite, often with cravings for seemingly high carb items. I wonder if our two friends in the aforementioned trials were already predisposed and additional carb intake was a trigger that tipped them over the edge?

Please note that I am not advocating everyone restrict their diet on Tx as I suspect a lot of the increased appetite may be our bodies telling us we need additional nutrition for healing. Rather I'm saying that those who are diabetic, pre-diabetic or have risk factors should consider that and tailor their diet to suit and the rest of us apply some moderation.......damn!!!! :ohmy:

......
G3a since '78 - Dx '12 - F4 (2xHCC)
24wk Tx - PEG/Riba/Dac 2013 relapsed
24wk Tx - Generic Sof/Dac/Riba 2015/16 relapsed
16wk Tx - 12/01/17 -> 03/05/17 NS3/NS5a + Generic Sof
SVR7 - 22/06/17 UND
SRV12 - 27/07/17 UND
SVR24 - 26/10/17 UND
:cheer: :cheer: :cheer:
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9296

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Hmmm, and a commonly discussed side from Tx with these DAAs seems to be an increased appetite, often with cravings for seemingly high carb items.

Yep, I can vouch for that GAJ :lol:
I needed to put on weight, but a few weeks in and at this rate I might be going on a diet!
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 5 years 10 months ago #9306

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Yeah, but it sure is nice to have the appetite back again and not suffer so much digesting afterwards...
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
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New-Onset Diabetes from Ledipasvir/Sofosbuvir 5 years 10 months ago #9317

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Craving sweets and carbs can be a sign of insulin resistance.

I found this....


"THE EFFECT OF DIABETES ON THE RESPONSE TO THE DIRECT-ACTING ANTI-VIRAL TREATMENTS
The recently approved sofosbuvir, simeprevir, ledipasvir, and the combination of paritaprevir, ombitasvir and dasabuvir have ushered in the era of interferon-free therapy for HCV hepatitis. These direct-acting anti-viral treatments (DAA) achieve SVRs of more than 90% for most treatment groups[71]. With such an effective treatment available it is likely that the effect of IR will be less evident. However, a recent preliminary report suggests that metabolic factors such as diabetes and hyperlipidemia still compromise the effect of DAA treatment. This was based on the results of a recent study that examined SVR at 12-wk in 54 non-Caucasian populations in the United States, 65% of whom were Hispanic and 24% had diabetes. SVR in this study was 81% which is lower than the rate reported in previous studies. A pre-treatment glucose level of less than 126 mg/dL was shown to be linked to a higher rate of SVR[72]. Further studies are needed to evaluate the effect of IR and diabetes on the response to DAA treatment. - "

hepatitiscnewdrugresearch.com/hepatitis-...sthash.qmfbgMrd.dpuf
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