direct-acting antivirals for chronic hepatitis C - risk of hypoglycaemia in patients with diabetes

Last edited 04/2019

  • glucose levels should be monitored closely in patients with diabetes during direct-acting antiviral therapy for hepatitis C, particularly within the first 3 months of treatment
    • modify diabetes medication or doses when necessary
  • patients with diabetes may experience symptomatic hypoglycaemia if diabetic treatment is continued at the same dose due to potential for an enhanced hypoglycaemic effect.

Advice for healthcare professionals:

  • rapid reduction in hepatitis C viral load during direct-acting antiviral therapy for hepatitis C may lead to improvements in glucose metabolism in patients with diabetes, potentially resulting in symptomatic hypoglycaemia

  • if diabetic treatment is continued at the same dose be vigilant for changes in glucose tolerance and advise patients of the risk of hypoglycaemia during direct-acting antiviral therapy, particularly within the first 3 months when the viral load is being reduced, and modify diabetic medication or doses when necessary

  • physicians who initiate direct-acting antiviral therapy in patients with diabetes should inform the healthcare professional in charge of the diabetic care of the patient

Notes (2):

  • direct-acting antiviral (DAA) eradication of HCV is associated with improved glycemic control in patients with diabetes as evidenced by decreased mean HbA1c and decreased insulin use

Reference:

Related pages:

hepatitis C and diabetes