Prevention of type 1 diabetes mellitus by early insulinization for chronic hepatitis C patient who has a high-titer Anti-GAD antibody before interferon plus ribavirin retherapy

A 68-year-old female with chronic hepatitis C (genotype lb, 6.7 LogIU/ml in load) was observed who developed type 1 diabetes mellitus (T1DM) after 3 months of peginterferon (PEGIFN) plus ribavirin (RBV) therapy. She was operated for liver cancer three years ago. Therefore, PEGIFN + RBV retherapy was necessary to be implemented. Before the retherapy, she was found to have a high-titer of glutamic acid decarboxylase antibodies (anti-GAD ab). However, 75 g oral glucose tolerance test was confirmed within normal limit and glucagon loading test showed a preserved endogenous insulin secretion. Hence, the prevention of occurrence of T1DM was raised the important problem. Although an early insulinization was initiated to prevent the occurrence of T1DM, she developed T1DM. There has been no case report previously, that the prevention of occurrence of T1DM for IFN-treated chronic hepatitis C patient was tried with an early insulin administration Thus, the progress of effective intervention for patients with chronic hepatitis C with anti-GAD ab is required.