Wil Dubois

Got questions about life with diabetes? So do we! That's why we offer our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois.

This week, Wil is taking on the tough topic of Hepatitis C and diabetes. This is a tricky one, as Hep C can be spread as a sexually transmitted disease (STD) but can also be spread through needles -- you know, like those used by many people with diabetes.Ask-DMine_button

Read on for Wil's POV...

{Got your own questions? Email us at [email protected]}


Kelly, type 1 from Rhode Island, writes: I have some friends who are IV drug users and they told me that you can get Hep C from your own needle nobody else has ever used before if you don’t bleach it before reusing it or if it gets rusty. This didn’t sound right to me, but since I know nothing of their hobby I said nothing. Is this true?

[email protected] D’Mine answers: You are correct and your IV drug-using buddies are wrong. Hep C is a virus -- and a highly contagious one -- but it belongs to the family of blood-borne pathogens. It can only spread through blood-to-blood contact.

Blood-to-blood means that infected blood must come into contact and mix with your clean blood to transmit the virus. Not that I recommend it, but you could literally soak your hands in Hep C-infected blood and, so long as your skin was intact with no open wounds, you wouldn’t catch the virus. It has to pass from blood to blood.

But when it comes to actual blood-to-blood contact, how much blood is needed? According to the World Health Organization, very little. Viruses are crazy-small, so a boatload of them can be found in even the smallest droplets of blood. But the virus doesn’t come out of thin air, so if you don’t have Hep C and you are the only one that uses — and reuses — a syringe, there is no way to “catch” Hep C from it. Rusty or not.insulin syringe

You might, however, catch something else from your personal rusty needle. More on that in a minute. But let’s finish up with hepatitis C first.

Hep C is a liver disease. It can trigger cirrhosis and sometimes lead to liver cancer. Globally, 71 million people are living with chronic hepatitis C, with 399,000 people dying annually from the disease.

The good news, at least for people living in “first world” nations, is that the latest antiviral meds have a cure rate of more than 95% with greatly reduced side effects compared to the meds used just a few short years ago. That said, in my opinion, not getting Hep C is still the best bet.

But if you still want to get in on the action, the easiest way to get Hep C is by using a “dirty” needle that someone who already has Hep C has used. In this case, what you’d be doing is actually injecting a small quantity of another user’s blood into your body, basically main-lining the virus right into you. For what it’s worth, the classic “dirty” needle can actually look sparkly clean to the naked eye, but still contain more than enough Hep C virus in micro droplets of blood to infect the next person who uses it. And the person after that.

For longer than you’d think.

Hep C is described as a “hardy” virus, and studies are mixed about the effectives of the bleach your buddies mentioned in killing it. Apparently it can live up to 63 days in a used syringe. Tough little sons of bitches.

Oh, and you can also catch Hep C through unscreened blood transfusions, from organ transplants before 1992, contaminated medical equipment, dirty tattoo or piercing parlors, and less commonly, though sex—depending on the kind of sex you enjoy. Scientists have studied sex and Hep C extensively—and why wouldn’t you if you could get a grant to do it?—and have discovered that heterosexual transmission of Hep C is rare.

How rare?

About 1 in 190,000 shags, although the risk goes up the more sex partners you have and the rougher you like your sex.

Boy-on-boy contact, by comparison, has been described as “far more efficient” when it comes to transmitting the virus. Although I couldn’t find a per sex act rate to help you judge your risk, Hep C in bi and gay men is being described as an epidemic.

So much for how you can get it. How can you not get it? Well, you can’t get Hep C by kissing someone who has it -- the virus lives in blood, not saliva -- or through food, water, or even breast milk. Or, as we said, from thin air on needles you only use yourself.

Hep C oddsOne of the challenges of Hep C, from the public health perspective, is that as many as 80% of people infected don’t develop any definitive symptoms, so they have no way to know they have it until liver damage shows up many years later. Of course, that doesn’t stop the virus from being spread from the unsuspecting victim to others in the meantime.

But back to your rusty needle. It is possible to get tetanus from one of those. Unlike Hep C, which is a virus, tetanus is a bacterial infection. Tetanus is serious shit. It affects nerves, triggering muscle contractions in the jaw and neck, hence it’s common name: Lockjaw. Untreated, it can kill you. For those morbid members of the crowd, it does this by suffocation. Those muscle contractions get so bad that they block the ability to breathe. It’s not curable, but it is preventable by a vaccine, which is only good for about 10 years, so you might want to consider a booster if it’s been a while since your last vaccination.

The tetanus germs, technically called Clostridium tetani, usually live in soil, dust, and animal feces, which is why stepping on an old nail at a construction site on a ranch is the classic way to get exposed. That said, according to the Mayo Clinic you can also catch tetanus from injection drug use (along with gunshot wounds, apparently).

So your IV drug-using buddies could be right about catching something from rusty syringes. They just had the wrong disease.


This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.
Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.