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Interesting Study on Insulin Resistance
J Hepatol. 2009 Apr;50(4):712-718.
Insulin resistance predicts response to peginterferon-alpha/ribavirin combination therapy in chronic hepatitis C patients.
Dai CY, Huang JF, Hsieh MY, Hou NJ, Lin ZY, Chen SC, Hsieh MY, Wang LY, Chang WY, Chuang WL, Yu ML.
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 807, Taiwan; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational and Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
BACKGROUND/AIMS: Insulin resistance (IR) might be associated with hepatitis C virus (HCV) infection. This study aimed to elucidate impact of IR and beta-cell function on the response to peginterferon-alpha (PEG-IFN)/ribavirin combination therapy in chronic hepatitis C (CHC) patients.
METHODS: Three hundred and thirty patients without overt diabetes were treated with combination therapy with (PEG-IFN)/ribavirin for 24 weeks. The IR and beta-cell function were evaluated by homeostasis model assessment of IR (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-beta) before treatment.
RESULTS: HCV genotype, pretreatment HCV RNA level and pretreatment HOMA-IR, but not HOMA-beta, were independent factors associated with sustained virologic response (SVR). In 150 patients with genotype 1b infection, pretreatment HCV RNA level, HOMA-IR and age were independent predictors for SVR. The significantly lower SVR rate in high HOMA-IR patients was observed in 76 patients with high HCV RNA levels (400,000IU/mL) who were defined as 'difficult-to-treat' patients. The mean HOMA-IR of 'difficult-to-treat' patients was significantly lower in 42 sustained responders than in 34 non-responders.
CONCLUSIONS: IR was associated with SVR to (PEG-IFN)/ribavirin therapy for CHC, especially among 'difficult-to-treat' patients. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
Insulin resistance predicts response to peginterferon-alpha/ribavirin combination therapy in chronic hepatitis C patients.
Dai CY, Huang JF, Hsieh MY, Hou NJ, Lin ZY, Chen SC, Hsieh MY, Wang LY, Chang WY, Chuang WL, Yu ML.
Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, No. 100, Tzyou 1st Rd, Kaohsiung 807, Taiwan; Faculty of Internal Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Occupational and Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
BACKGROUND/AIMS: Insulin resistance (IR) might be associated with hepatitis C virus (HCV) infection. This study aimed to elucidate impact of IR and beta-cell function on the response to peginterferon-alpha (PEG-IFN)/ribavirin combination therapy in chronic hepatitis C (CHC) patients.
METHODS: Three hundred and thirty patients without overt diabetes were treated with combination therapy with (PEG-IFN)/ribavirin for 24 weeks. The IR and beta-cell function were evaluated by homeostasis model assessment of IR (HOMA-IR) and homeostasis model assessment of beta-cell function (HOMA-beta) before treatment.
RESULTS: HCV genotype, pretreatment HCV RNA level and pretreatment HOMA-IR, but not HOMA-beta, were independent factors associated with sustained virologic response (SVR). In 150 patients with genotype 1b infection, pretreatment HCV RNA level, HOMA-IR and age were independent predictors for SVR. The significantly lower SVR rate in high HOMA-IR patients was observed in 76 patients with high HCV RNA levels (400,000IU/mL) who were defined as 'difficult-to-treat' patients. The mean HOMA-IR of 'difficult-to-treat' patients was significantly lower in 42 sustained responders than in 34 non-responders.
CONCLUSIONS: IR was associated with SVR to (PEG-IFN)/ribavirin therapy for CHC, especially among 'difficult-to-treat' patients. These findings suggested clinical application of pretreatment HOMA-IR could enable treatment outcome to be predicted and treatment regimens to be determined.
Just read your second post.
Look, diet and exercise can be difficult and not everyone responds the same and maybe you are doing all you can do, it's really hard to say as all I know is from the other end of a computer screen.
Did you check out the South Beach Diet Links I sent you some time back?
If interested, check out "PHASE 1" and give it a try for 2-3 weeks. I think you will find it more carb restricted than what you are doing and I wouldn't be surprised if it will bring down some of those numbers you posted.
Of course, run the diet by whatever doctor you're seeing for HCV to make sure it's OK in your case. Maybe that will help or maybe the IR sensitizers are the way to go. As prev stated, I'm not the right person to make that call.
Again, you should be commended on your determination. Good luck!
-- Jim
Look, diet and exercise can be difficult and not everyone responds the same and maybe you are doing all you can do, it's really hard to say as all I know is from the other end of a computer screen.
Did you check out the South Beach Diet Links I sent you some time back?
If interested, check out "PHASE 1" and give it a try for 2-3 weeks. I think you will find it more carb restricted than what you are doing and I wouldn't be surprised if it will bring down some of those numbers you posted.
Of course, run the diet by whatever doctor you're seeing for HCV to make sure it's OK in your case. Maybe that will help or maybe the IR sensitizers are the way to go. As prev stated, I'm not the right person to make that call.
Again, you should be commended on your determination. Good luck!
-- Jim
Last sentence, third paragraph should read in part...
"...then I guess you have to do the best you can do but I'm not sure how anyone can tell you too much more unless theyre a medical professional WITH your complete charts, etc."
"...then I guess you have to do the best you can do but I'm not sure how anyone can tell you too much more unless theyre a medical professional WITH your complete charts, etc."
Well said Jim.
The discussion above was about the general population, but in the real world things have to be addressed case by case.
So for that reason it's impossible to answer your question because so much depends on exactly what type of diet and exercise program you're on, how well you are complying, your pre-program BMI, your BMI right now, and how much of a strain boosting the diet and exercise program would be. Maybe it's a good idea to have your program re-evaluated by a doctor and/or nutritionist or perhaps it's not and you should explore other options such as the IR sensitizes discussed.
My suggest to you has always been the same. Get a liver biopsy to pin point exactly how much damage you have and then find yourself a good hepatologist who can help put the whole thing together. And given the new research on the IR sensitizers, if it were me, I'd print out a whole lot of those studies and bring them with me to the doctor. If the aforementioned is unrealistic, then I guess you have to do the best you can do but I'm not sure how anyone can tell you too much more unless theyre a medical professional without your complete charts, etc.
I do wish you the very best, however, as you do seem determined to fight this thing which is a long way from when you first joined here and were only relying on input from your local doctor.
-- Jim
So for that reason it's impossible to answer your question because so much depends on exactly what type of diet and exercise program you're on, how well you are complying, your pre-program BMI, your BMI right now, and how much of a strain boosting the diet and exercise program would be. Maybe it's a good idea to have your program re-evaluated by a doctor and/or nutritionist or perhaps it's not and you should explore other options such as the IR sensitizes discussed.
My suggest to you has always been the same. Get a liver biopsy to pin point exactly how much damage you have and then find yourself a good hepatologist who can help put the whole thing together. And given the new research on the IR sensitizers, if it were me, I'd print out a whole lot of those studies and bring them with me to the doctor. If the aforementioned is unrealistic, then I guess you have to do the best you can do but I'm not sure how anyone can tell you too much more unless theyre a medical professional without your complete charts, etc.
I do wish you the very best, however, as you do seem determined to fight this thing which is a long way from when you first joined here and were only relying on input from your local doctor.
-- Jim
Forgot to add the weight I have lost is minimal and YES I know it is about excercise it is difficult for me to excercise if I excercise it totally wipes me out I need to start small 5 minutes of walking I am not terribly obese but am obese at 30 pounds overweight I was able to take 10 pounds off but am stuck I eat well oatmeal with bran lots of large salads and chicken or fish and some red meat but not often I cut way back on carbohydrates my downfall is peanuts in the shell but will stop those and see if that makes a difference I do not let me body go into starvation mode and try very hard to eat balanced snacks during the day I do eat beef jerky and yougart no fat or sugar eat berries and fresh picked lettuce and other greens and flowers in all my salads
I am taking all my sups regularly I have done research and except for the curcumin not one seem to mess with insulin levels?
baja
I am taking all my sups regularly I have done research and except for the curcumin not one seem to mess with insulin levels?
baja
let me see if this makes any sense to anyone here feed back appreciated these are my labs from november
INSULINA 12 uUl/ml
GLUCOSA 103 mg/dl
UREA 31 mg/dl
BUN 14 mg/dl
CREATININA 0.94 mg/dl
URICO 4.0 mg/dl
COLESTEROL 171
TRIGLICERIDOS 198
VLDL 40
These labs below were taken last week also my CAT scan showed NO fatty liver and the Ultra sound I had in November showed stage two fatty liver ???
HOMA IN NOVEMBER 08 3
HEMOGLOBINA GLICADA 4.5
INSULINA 11.9 uUl/ml
GLUCOSA 102 mg/dl
UREA 49 mg/dl
CREATININA 1.1 mg/dl
ACIDO URICO 4.2 mg/dl
COLESTEROL 183 mg/dl
TRIGLICERIDOS 140 mg/dl this was the major change in my labs as I see it but I am not a professional
I would have expected a drop in Glucose and Insulin with the diet I am on but nothing ??? HOMA IN MARCH 09 2.99 NO CHANGE NOW WHAT TRY HARDER HOW?
baja
INSULINA 12 uUl/ml
GLUCOSA 103 mg/dl
UREA 31 mg/dl
BUN 14 mg/dl
CREATININA 0.94 mg/dl
URICO 4.0 mg/dl
COLESTEROL 171
TRIGLICERIDOS 198
VLDL 40
These labs below were taken last week also my CAT scan showed NO fatty liver and the Ultra sound I had in November showed stage two fatty liver ???
HOMA IN NOVEMBER 08 3
HEMOGLOBINA GLICADA 4.5
INSULINA 11.9 uUl/ml
GLUCOSA 102 mg/dl
UREA 49 mg/dl
CREATININA 1.1 mg/dl
ACIDO URICO 4.2 mg/dl
COLESTEROL 183 mg/dl
TRIGLICERIDOS 140 mg/dl this was the major change in my labs as I see it but I am not a professional
I would have expected a drop in Glucose and Insulin with the diet I am on but nothing ??? HOMA IN MARCH 09 2.99 NO CHANGE NOW WHAT TRY HARDER HOW?
baja
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