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      Treatment of type 2 diabetes mellitus by viral eradication in chronic hepatitis C: Myth or reality?

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          Abstract

          Chronic hepatitis C is a systemic disease inducing metabolic alterations leading to extrahepatic consequences. In particular, hepatitis C virus (HCV) infection seems to increase the risk of incident type 2 diabetes mellitus in predisposed individuals, independently of liver disease stage. The mechanisms through which hepatitis C induces T2DM involve direct viral effects, insulin resistance, pro-inflammatory cytokines and other immune-mediated processes. Many studies have reported the clinical consequences of type 2 diabetes mellitus on hepatitis C outcome, but very few studies have addressed the issue of microangiopathic complications among patients with hepatitis C only, who develop type 2 diabetes mellitus. Moreover, clinical trials in HCV-positive patients have reported improvement in glucose metabolism after antiviral treatment; recent studies have suggested that this metabolic amelioration might have a clinical impact on type 2 diabetes mellitus-related complications. These observations raise the question as to whether the HCV eradication may also have an impact on the future morbidity and mortality due to type 2 diabetes mellitus. The scope of this review is to summarise the current evidence linking successful antiviral treatment and the prevention of type 2 diabetes mellitus and its complications in hepatitis C-infected patients.

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          Author and article information

          Journal
          Dig Liver Dis
          Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
          1878-3562
          1590-8658
          Feb 2016
          : 48
          : 2
          Affiliations
          [1 ] Gastro-hepatology Unit, Department of Medical Sciences, University of Turin, Turin, Italy.
          [2 ] Gastroenterology Unit, Oncology Department, University of Turin, Italy. Electronic address: g.saracco@tin.it.
          Article
          S1590-8658(15)00658-1
          10.1016/j.dld.2015.10.016
          26614641
          Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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