Prevalence and Clinical Significance of Diabetes Mellitus in Patients with Liver Cirrhosis

Korean J Hepatol > Volume 9(3); 2003 > Article

The Korean Journal of Hepatology 2003;9(3): 205-211.

Prevalence and Clinical Significance of Diabetes Mellitus in Patients with Liver Cirrhosis

Kwon So Yeong

Department of Internal Medicine, National Medical Center, Seoul, Korea

ABSTRACT

Background/Aims
Impaired glucose tolerance and overt diabetes mellitus (DM) frequently occurs in patients with chronic liver disease. Hyperinsulinaemia and peripheral insulin resistance contribute to the development of DM in these patients. The clinical relevance, however, of DM to their clinical course was not determined. We investigated the prevalence of DM in patients with liver cirrhosis and their chinical characteristics and prognosis. Methods: A total of 606 consecutive cirrhotic patients were enrolled for 5 year. We reviewed all prognosis. findings, clinical courses, and mortality, retrospectively. The cirrhotic patients were divided into two groups according to the presence of DM, and their clinical characteristics and mortality were compared. DM was diagnosed in accordance with National Diabetes Data Group criteria. Results: Among the total of 606 cirrhotic patients (M:F, 482:124), 346 (57.1%) had HBV related disease and 60 (10%) had HCV related disease. Forty-five percent of the patients had a history of habitual drinking. DM was observed in 22.4% of the cirrhotic patients. In the diabetic group, the frequency of HCV infection was significant greater. DM did not affect survival. The DM group, however, appeared to have higher mortality in the patients with Child-Pugh class A cirrhosis during long-term follow up, Only 20.6% of the diabetic patients had normal range blood glucose levels even though most of them received medical therapy, The cases with well controlled blood glucose showed higher survival than poorly controlled cases in the DM group. Conclusions: Cirrhotic patients have a high prevalence of DM, and more frequently are associated with HCV infection. The strict control of blood glucose and the control of infection could be important in prolonging the survival in compensated cirrhotic patients with DM.(Korean J Hepatol 2003;9:205-211)

KeyWords: Liver cirrhosis, Diabetes mellitus, Hepatitis C, Prognosis