Aa
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.
thank you for the information here is my thyroid panel
INDICE DE TIROXINA LIBRE ITL 2.20 %
T3 CAPTIACION 25.3 %
T3 TRIYODOTIRONINA LIBRE T3F 3.39 pg/ml
T3 TRIYODOTIRONINA TOTAL 108 ng/dl
T4 TIROXINA LIBRE T4F 1.09 ng/dl
T4 TIROXINA TOTAL 8.72 ug/dl
RTH TSH TIROTROPINA 1.50 uUl/mL
My doctor said it was fine?
I have the Zone very good diet plan and very similar to the Insulin Resistance diet
which I think I follow pretty good but the PORTION CONTROL is a factor for me I am so hungry I am eating breakfast for the first time in years
but am really starving at 11am and again throughout the day
fasting before a blood test is really hard on me to do I dread it as I feel so woosy and dizzy and feel very bad when my body is in starvation mode
there is another factor I think for some that eating time can bring anxiety from past experiences or lifestyle and I think most people in a rush do not enjoy what they eat
or how they eat this is something I personally want to work on but always being in a hurry is a definate factor for me and with people on tx it is an anxious time as stated here as they cannot keep it down or most foods just are not appealing
Excercise I get so much bad excercise at work I am very active moving things and it is tiring and causes pain but that is part of my job decoration in my one business I love it but it tires me out to no end
I am very strong and overdo also being on my feet which has always been easy for me is now painful but so is laying down after sleeping there is a lot of pain upon waking
too much info???
but thanks for your post I have to admit I do not understand much of the IR Diabetes Info
just wondering if I could have both as having HCV for the length of time I have had I figure it is throughout my body rather than damaging my liver which you would think would be the case it seems to have affected my body in many ways and not my liver??
Can a person who is always in survival mode have less damage to the liver? does having HCV in your brain stem or brain cause other issues in your body? or is it the virus in those organs?
baja
INDICE DE TIROXINA LIBRE ITL 2.20 %
T3 CAPTIACION 25.3 %
T3 TRIYODOTIRONINA LIBRE T3F 3.39 pg/ml
T3 TRIYODOTIRONINA TOTAL 108 ng/dl
T4 TIROXINA LIBRE T4F 1.09 ng/dl
T4 TIROXINA TOTAL 8.72 ug/dl
RTH TSH TIROTROPINA 1.50 uUl/mL
My doctor said it was fine?
I have the Zone very good diet plan and very similar to the Insulin Resistance diet
which I think I follow pretty good but the PORTION CONTROL is a factor for me I am so hungry I am eating breakfast for the first time in years
but am really starving at 11am and again throughout the day
fasting before a blood test is really hard on me to do I dread it as I feel so woosy and dizzy and feel very bad when my body is in starvation mode
there is another factor I think for some that eating time can bring anxiety from past experiences or lifestyle and I think most people in a rush do not enjoy what they eat
or how they eat this is something I personally want to work on but always being in a hurry is a definate factor for me and with people on tx it is an anxious time as stated here as they cannot keep it down or most foods just are not appealing
Excercise I get so much bad excercise at work I am very active moving things and it is tiring and causes pain but that is part of my job decoration in my one business I love it but it tires me out to no end
I am very strong and overdo also being on my feet which has always been easy for me is now painful but so is laying down after sleeping there is a lot of pain upon waking
too much info???
but thanks for your post I have to admit I do not understand much of the IR Diabetes Info
just wondering if I could have both as having HCV for the length of time I have had I figure it is throughout my body rather than damaging my liver which you would think would be the case it seems to have affected my body in many ways and not my liver??
Can a person who is always in survival mode have less damage to the liver? does having HCV in your brain stem or brain cause other issues in your body? or is it the virus in those organs?
baja
I think getting the BMI is important, much more than my doc thinks.
However, one has to be careful how one achieves that with HCV.and especially with any iron overload or IR on board.
reason being is fasting causes big issues as does too much excercsie with oxidative stress which in turn causes more liver harm.
So dieting should be renamed portion contol and excersise should be light to moderate to avoid oxidative stressand muscle acid build ups.
Because once on tx red blood cells can be cut by 30-50% of normal, activity is not always an option.
However, one can help ones blood sugar out a lot by 7 small half meals a day.
the 7th meal should be a glass of milk and grahm cracher, or a small piece of chesse with a couple slices of apple, taken at mifnight or upon wakinf during the night,
CTUALLY EATING THAT LATE WILL HELP YOUR MORNING BLOOD SUGARS TO BE LOWER believe it or not, by having some available fuel through the night it slows the production of hormones that tend to raise BS overnight,
I'd really recommend you take a look at Barry's Sears "The Zone" diet...in paperback everywhere.
This is the only diet book I know of that explains IR and diebetes and food matabolism so that any person of average intelligence can fully understand it. His chapter on Insulin Production alone is worth the price of admission.
Even if you don't like "the point" system he used for keeping track of foods, you can still follow the principal of combining protein/carbs/fats in the right proportion is each meal or snack, and this combing alone will greatly effect IR.
mb
However, one has to be careful how one achieves that with HCV.and especially with any iron overload or IR on board.
reason being is fasting causes big issues as does too much excercsie with oxidative stress which in turn causes more liver harm.
So dieting should be renamed portion contol and excersise should be light to moderate to avoid oxidative stressand muscle acid build ups.
Because once on tx red blood cells can be cut by 30-50% of normal, activity is not always an option.
However, one can help ones blood sugar out a lot by 7 small half meals a day.
the 7th meal should be a glass of milk and grahm cracher, or a small piece of chesse with a couple slices of apple, taken at mifnight or upon wakinf during the night,
CTUALLY EATING THAT LATE WILL HELP YOUR MORNING BLOOD SUGARS TO BE LOWER believe it or not, by having some available fuel through the night it slows the production of hormones that tend to raise BS overnight,
I'd really recommend you take a look at Barry's Sears "The Zone" diet...in paperback everywhere.
This is the only diet book I know of that explains IR and diebetes and food matabolism so that any person of average intelligence can fully understand it. His chapter on Insulin Production alone is worth the price of admission.
Even if you don't like "the point" system he used for keeping track of foods, you can still follow the principal of combining protein/carbs/fats in the right proportion is each meal or snack, and this combing alone will greatly effect IR.
mb
sevral things:
yes one could have both HCV caused and peripheral.
Your BS's are not bad but have you had your thyroid checked. The easiest way to correct for triglycerides is to be sure you stay in the .1-1.5 range, if your TSH number is 2,3,4 or higher this will rei triglycerides, so a low dose of synthroid can really help there.
It used to be a 2 or 3 was consider fine, but not anymore.
not only can you have 2 types IR, but MANY types of diebetes:
A number of other types of diabetes exist. A person may exhibit characteristics of more than one type.
For example, in latent autoimmune diabetes in adults (LADA), also called type 1.5 diabetes or double diabetes, people show signs of both type 1 and type 2 diabetes.
Other types of diabetes include those caused by
genetic defects of the beta cell—the part of the pancreas that makes insulin—such as maturity-onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM)
genetic defects in insulin action, resulting in the body’s inability to control blood glucose levels, as seen in leprechaunism and the Rabson-Mendenhall syndrome
diseases of the pancreas or conditions that damage the pancreas, such as pancreatitis and cystic fibrosis
excess amounts of certain hormones resulting from some medical conditions—such as cortisol in Cushing’s syndrome—that work against the action of insulin
medications that reduce insulin action, such as glucocorticoids, or chemicals that destroy beta cells
infections, such as congenital rubella and cytomegalovirus
rare immune-mediated disorders, such as stiff-man syndrome, an autoimmune disease of the central nervous system
genetic syndromes associated with diabetes, such as Down syndrome and Prader-Willi syndrome
yes one could have both HCV caused and peripheral.
Your BS's are not bad but have you had your thyroid checked. The easiest way to correct for triglycerides is to be sure you stay in the .1-1.5 range, if your TSH number is 2,3,4 or higher this will rei triglycerides, so a low dose of synthroid can really help there.
It used to be a 2 or 3 was consider fine, but not anymore.
not only can you have 2 types IR, but MANY types of diebetes:
A number of other types of diabetes exist. A person may exhibit characteristics of more than one type.
For example, in latent autoimmune diabetes in adults (LADA), also called type 1.5 diabetes or double diabetes, people show signs of both type 1 and type 2 diabetes.
Other types of diabetes include those caused by
genetic defects of the beta cell—the part of the pancreas that makes insulin—such as maturity-onset diabetes of the young (MODY) or neonatal diabetes mellitus (NDM)
genetic defects in insulin action, resulting in the body’s inability to control blood glucose levels, as seen in leprechaunism and the Rabson-Mendenhall syndrome
diseases of the pancreas or conditions that damage the pancreas, such as pancreatitis and cystic fibrosis
excess amounts of certain hormones resulting from some medical conditions—such as cortisol in Cushing’s syndrome—that work against the action of insulin
medications that reduce insulin action, such as glucocorticoids, or chemicals that destroy beta cells
infections, such as congenital rubella and cytomegalovirus
rare immune-mediated disorders, such as stiff-man syndrome, an autoimmune disease of the central nervous system
genetic syndromes associated with diabetes, such as Down syndrome and Prader-Willi syndrome
Willing,
I don't recall any difference in my glucose post treatment. Recently I put on some weight and that seems to have increased my BG. And, often the weight comes with increased carbohydrate intake so that played a role as well. I have lost some of the weight by abstaining from carbs and as a result my insulin requirement has decreased.
CO,
After 2 years of treatment I lost a lot of weight. I weighed between 140 & 145 lbs and I had treated with 800 mg ribavirin per day my first 2 treatments. For the third treatment my ribavirin dose was 1000 mg per day.
During my second treatment I did become undetectable but quite late in my treatment - guessing I would say between week 20 to week 28. I stopped at week 52/53 and relapsed immediately.
My third treatment I was undetectable per Heptimax at week 12 but I assume I was clear at week 11 because week 10 VL was 15 IU/ml or thereabouts.
Mike
I don't recall any difference in my glucose post treatment. Recently I put on some weight and that seems to have increased my BG. And, often the weight comes with increased carbohydrate intake so that played a role as well. I have lost some of the weight by abstaining from carbs and as a result my insulin requirement has decreased.
CO,
After 2 years of treatment I lost a lot of weight. I weighed between 140 & 145 lbs and I had treated with 800 mg ribavirin per day my first 2 treatments. For the third treatment my ribavirin dose was 1000 mg per day.
During my second treatment I did become undetectable but quite late in my treatment - guessing I would say between week 20 to week 28. I stopped at week 52/53 and relapsed immediately.
My third treatment I was undetectable per Heptimax at week 12 but I assume I was clear at week 11 because week 10 VL was 15 IU/ml or thereabouts.
Mike
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