Prevalence of Hepatogenous Diabetes in Cirrhotic Patients - A Cross Sectional Study
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Diabetes manifests clinically as liver function deteriorates which is coined as Hepatogenous Diabetes [HD]. The presence of HD in cirrhotic patients is considered as an indicator of advanced liver disease. This cross sectional study comprising of 88 Cirrhotic patients was done to assess the prevalence of HD in cirrhotic patients in a tertiary care centre in Chennai, South India. Patients were assessed for liver function, Insulin resistance was measured by fasting insulin levels and incorporating in HOMA-IR formula and DM was diagnosed by Fating plasma glucose levels. Analysis of glycemic status revealed presence of hepatogenous diabetes in 12.5% and those with glucose intolerance were 21.6 %. The above two groups totalling34.1 %, exhibits prevalence similar to the prevalence of HD observed in previous studies (20-60%).Insulin resistance calculated by HOMA-IR reveals increasing values across the groups with HOMA-IR values of 3.36 in intolerance group and 6.97 in overt Diabetic group respectively. Absence of therapeutic guidelines or recommendations for these patients present further challenges in therapy and these patients frequently encounter hypoglycemia. Hence early identification of glycemic impairement will help clinician in planning therapy and assessing prognosis. Also it is recommended that cirrhotic patients be screened for DM by OGTT as these patients may present with a normal fasting plasma glucose level and HbA1C levels, which is a limitation in the current study. The prevalence of Hepatogenous Diabetes is 12.5 % in cirrhotic patients, which is higher than the incidence in general population estimated at 5%.
Authors and Affiliations
Dr. D. Revathi, Dr. G. Komala, Dr. B. Lavanya Devi, Dr. Vikraman, Dr. Aravinth Srinivas, Dr. R. Lalitha
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