Abrupt onset of diabetes during interferon-alpha therapy in patients with chronic hepatitis C

Introduction Interferon-alpha (IFN-alpha) is now widely used in the treatme nt of chronic hepatitis C. Few patients have been reported as developing im paired glucose tolerance or diabetes mellitus (DM) using this therapy. The explanation for the development of DM in chronic hepatitis C treated with I FN-alpha is unclear. We report two patients who developed an abrupt onset o f diabetes during IFN-alpha for chronic hepatitis C. Case reports Two male middle-aged patients were admitted to our hospital fo r an abrupt onset of diabetes, in diabetic ketoacidosis, with a very short duration of hyperglycaemic symptoms. Their clinical course was similar. Cas e 1 never demonstrated any markers of pancreatic immunogenicity. Case 2 had high levels of decarboxylase glutamic acid autoantibodies (GADAb), before the IFN-alpha treatment that persisted. We compared initial beta -cell func tion and metabolic control with a group of middle-aged patients from our ho spital who had recently been diagnosed with Type 1 diabetes mellitus (DM1). In contrast to these, the onset of the disease was particularly severe wit h beta -cell function substantially impaired and displaying unstable short- term metabolic control. Conclusions Type 1 diabetes should be considered as a potential complicatio n if IFN is administered to patients with chronic hepatitis C. Its onset ma y be severe and result in short-term difficulties in metabolic control.