Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Flamm1 did
not discuss the association between chronic HCV infection and diabetes mellitus,
nor its mechanism. Several studies from different parts of the world have
found that 13% to 33% of patients with chronic HCV infection have associated
diabetes, mostly type 2 diabetes.2,3 The
increased prevalence of diabetes in patients with HCV without cirrhosis or
other confounding factors3 is important
as cirrhosis is commonly associated with impaired glucose tolerance, regardless
of etiology. Thus, diabetes appears to be a unique extrahepatic manifestation
of chronic HCV infection. The National Health and Nutrition Examination Survey
III study4 has estimated an adjusted odds
ratio of 3.37 of diabetes in patients older than 40 years with chronic HCV
Schattner A, Knobler H. Clinical Aspects of Chronic Hepatitis C InfectionClinical Aspects of Chronic Hepatitis C Infection. JAMA. 2003;290(11):1452. doi:10.1001/jama.290.11.1452-a
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