Insulin resistance plays an essential role in the pathogenesis of diabetes associated with HCV. High levels of inflammatory cytokines have been found in HCV-infected patients. The aim of the study was to investigate the association of HCV infection with impaired glucose metabolism and to highlight the role of inflammatory cytokines as an initial mechanism involved in insulin resistance development in HCV infection. It included 3 groups of patients: Group I: 50 HCV patients with DM. Group II: 50

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... HCV patients without DM and Group III: 25 patients with DM alone as control subjects. Insulin resistance was evaluated using the (HOMA-IR) index. We measured the levels of fasting insulin, CRP and two of the inflammatory cytokines of the innate immunity (TNF-α and IL-6 by ELISA). It was found that insulin resistance, CRP and IL6 in group (I) were significantly higher when compared to group (II) and (III) with P-value < 0.001. CRP in group (II) was significantly higher when compared to group (III) with P-value < 0.05. Serum level of (TNF-α) in group (I) was significantly higher when compared to group (II) with P-value < 0.05 and group (III) with P-value < 0.001 as well as in group (II) it was significantly higher when compared to group (III) with P-value < 0.001. CRP, IL-6 and TNF-α had statistically significant positive direct correlation to insulin resistance. In conclusion there was a strong relationship between inflammatory cytokines and the occurrence of insulin resistance in chronic HCV patients with type 2 diabetes mellitus.