TOPIC: Blood sugar and insulin resistance going up during treatment

Hello all again!

How are you all doing?

I've just had my middle of treatment exams and I'm happy to report I'm undetectable. That's awesome. My AST and ALT levels went from 39 and 60 to 18 on both. This is amazing. I know it's common on treatment but it still impresses me. Low levels like that means that my liver is not inflamed anymore? I have steatosis and I was wondering if levels like these can rule out that the fat is affecting my liver inflammation. I heard of cases with people that were treated from hep c that the liver enzymes were still high because of fat liver. I'm getting rid of the fat but it would be nice to know that my liver can have a deserved rest while I do my job.

But not all were good news. My fasting blood sugar level increase from 94 (range is 99) to 108 which means that now I'm pre-diabetic from what I understand.

Also, my insulin resistance level went through the roof. Max value is 25 and I'm 65. Before treatment I was 39.

I understand that I'm obese and high values are expected, but I've lost weight after I've started the treatment with Viekira Pak and Ribavirine. So I was expecting at least to get the same levels.

My concern is that I've read somewhere here at the forum that some people got diabetic after treatment for some reason and they were obese like I am before starting treatment.

Does anyone know if the medication increase sugar levels? Can I become diabetic?

Also, my ALP levels that used to be 60 (max value 120) is now 130. Should I be worried? Can this be due to medication? I just hope I'm not cirrhotic or anything like that.

Thanks!

Hi John,

Diabetes is 3 x as common in people with Hep C.

It's also considerably more common in people who are overweight.

Diabetes just needs to be looked at, and treated, on its merits with no consideration of the Hep C.

We do see pre-diabetes resolve in overweight patients who loose weight, but this is easier said than done. The diabetes medication Metformin is the commonest starting med and interestingly helps about 50% of people lose some weight.

When you say Metamorfin is a starting medication you mean it’s a diabetes or pre-diabetes medication?

How long does it take to get from pre-diabetes to diabetes? Ten months ago my blood sugar level was 94 and my Hb1Ac was 5.4

I’m already changing my lifestyle but I need some time to lose the weight.

Thanks

My only concern is that my labs seem worse during treatment. As I’ve mentioned ALP doubled, my glucose went up and my INR is 1.16 which seems a disaster to those cirrhosis equations like Gucci and CDS.

Can this be caused by the meds? Also, I was taking motoprolol at the time.

I was hoping that everything would be better.

Hi John,

Why don't you book in with me on gp2u.com.au/ and we can run through all your worries?

That’s a great idea! I think it would be more appropriate and efficient. It makes more sense.

I’m on the end of treatment. Less than two weeks to go. Just let me finish it and make new exams and I’ll schedule an appointment with you so we can discuss what I can expect from now on.

Thank you for your patience and kindness. I know I’m not the easiest patient to deal with.

Thank you very much.