Can Autoimmune Hepatitis (AIH) or Viral Hepatitis lead to Diabetes Mellitus (DM)?

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From the Guidelines

Yes, Autoimmune Hepatitis (AIH) and Viral Hepatitis can lead to Diabetes Mellitus (DM).

Key Findings

  • Viral Hepatitis, specifically Hepatitis C Virus (HCV) infection, is associated with a higher prevalence of type 2 diabetes, present in up to one-third of individuals with chronic HCV infection 1.
  • The mechanisms by which HCV impairs glucose metabolism include direct effects via viral proteins and indirect effects by altering proinflammatory cytokine levels 1.
  • Autoimmune Hepatitis (AIH) treatment, particularly with prednisolone, is associated with an increased risk of developing side effects such as diabetes 1.

Evidence Summary

  • Studies have consistently shown that HCV infection is linked to an increased risk of developing type 2 diabetes, with a mean reduction in A1C levels of 0.45% following successful eradication of HCV infection 1.
  • The use of direct-acting antiviral drugs has been reported to improve glucose metabolism in individuals with diabetes and HCV infection 1.
  • In AIH, the main long-term management goals include minimizing the risk of disease relapse, liver-related death or transplantation, and side effects of treatment, such as diabetes 1.

Clinical Implications

  • Patients with Viral Hepatitis, particularly HCV, should be screened for diabetes and monitored for glucose metabolism disturbances.
  • Individuals with AIH should be aware of the potential risk of developing diabetes as a side effect of treatment and monitored accordingly.
  • The management of diabetes in patients with Viral Hepatitis or AIH should be tailored to the individual's specific needs, taking into account the underlying liver disease and potential interactions with antiviral or immunosuppressive therapies.

From the Research

Association between Autoimmune Hepatitis (AIH) and Diabetes Mellitus (DM)

  • Autoimmune liver diseases, including AIH, have been linked to an increased risk of developing diabetes, with potential underlying mechanisms including genetic predisposition, concurrent nonalcoholic fatty liver disease (NAFLD) and/or cirrhosis development, and treatment-related impairment of glucose homeostasis 2, 3.
  • A study using data from the United Kingdom Biobank found that patients with AIH had a significantly increased risk of type 1 diabetes (T1D) and type 2 diabetes (T2D) compared to matched controls 3.
  • The pooled prevalence of T1D and T2D in patients with AIH was found to be 3.8% and 14.8%, respectively, in a systematic review and proportional meta-analysis 3.

Association between Viral Hepatitis and Diabetes Mellitus (DM)

  • Chronic hepatitis C (CHC) infection has been shown to increase the risk of developing diabetes, with several cohort studies demonstrating an association between CHC and insulin resistance, as well as an increased risk of macro and microvascular complications in patients with known diabetes 4, 5.
  • The mechanisms underlying the association between CHC and diabetes are complex and bidirectional, with CHC infection inducing insulin resistance and promoting β-cell dysfunction, and diabetes increasing the risk of liver-related events in patients with CHC 4, 5.
  • Hepatitis C virus (HCV) infection has also been linked to an increased risk of type 1 diabetes, although the data on this association are limited compared to type 2 diabetes 6, 5.

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

2
Research

Autoimmune liver diseases and diabetes.

European journal of gastroenterology & hepatology, 2023

3
Research

Autoimmune liver diseases and diabetes: A propensity score matched analysis and a proportional meta-analysis.

Liver international : official journal of the International Association for the Study of the Liver, 2023

6
Research

Hepatitis C virus and type 1 diabetes.

La Clinica terapeutica, 2013

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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