Bilal Bin Younas, Gulsana Masood Khan, M Akbar Chaudhary.
Prevalence of Diabetes Mellitus among Patients suffering from Chronic Liver Disease.
Mother & Child Jan ;38(1):37-40.

A study was conducted on 120 patients admitted with chronic liver disease (CLD) in Medical Unit 2 of Sir Ganga Ram Hospital Lahore during 1999 to document the associated diseases seen in these patients. CLD was diagnosed on the basis of clinical features, liver function tests and ultrasonography. These patients were evaluated for associated diseases particularly the diabetes mellitus. Nearly 1/3 of subjects (28.3%) didnot have any associated disease. Diabetes Mellitus was present in significantly higher (p<0.05) number of cases (41.7%) cases as compared to tuberculosis in 18.3%. Chronic Obstructive Pulmonary disorder (COPD) in 13.3% and Ischemic Heart Disease in 6.7% patients. Conclusion: Glucose intolerance is encountered in majority of cirrhotic patients. A reduction in first pass hepatic metabolism of ingested glucose and a decrease insulin-mediated glucose uptake in peripheral tissues have been implicated as a cause of glucose intolerance in cirrhotic patients. Main cause of decrease glucose handling is suggested to be an impaired non-oxidative glucose disposal (glycogen synthesis). Increase insulin concentrations, both in fasting state and after glucose stimulus, was observed in almost all cirrhotic patients. This increase has either been attributed to a hyper-production by pancreatic beta cells or a reduced insulin degradation by cirrhotic liver. Hepatitis C virus may be an additional risk factor for the development of diabetes mellitus and there is relatively strong association between hepatitis C virus infection and diabetes because diabetics have an increased frequency of hepatitis C virus infection particularly with genotype 2a.

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