Clinical implications of hepatogenous diabetes in liver cirrhosis

Holstein, Andreas; Hinze, S; Thiessen, Ekkart; Plaschke, A.; Eh, Egberts

doi:10.1046/j.1440-1746.2002.02755.x

Cited by 173 publications

(161 citation statements)

References 29 publications

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“…The prevalence of DM in cirrhosis has been reported from 20-60%. [16][17][18][19] In our study, the prevalence of DM was 15.3%. Apart from a higher prevalence in cirrhotic, DM is also associated with more incidence of hypoglycemia, especially with oral hypoglycemic agents (OHA) and hence insulin is recommended for its control.…”

Section: Discussionsupporting

confidence: 44%

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

2017

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Background: Peripheral neuropathy is not an uncommon complication of liver cirrhosis but it is not given much clinical relevance. The pattern and prevalence of peripheral neuropathy has also not been studied extensively. Alcohol use, coexisting diseases and nutritional deficiency have been postulated as factors responsible for neuropathy. The aim of this study was to define the pattern and prevalence of neuropathy in cirrhosis and to determine any etiologic correlation.Methods: 85 patients of cirrhosis of liver were studied. Apart from routine investigations, serum vitamin B12 estimation was also done in these patients. Electrophysiological studies were done in 46 patients.Results: Alcohol was the most common etiology of cirrhosis (57.6%). Hepatitis B related (11.8%) and Hepatitis C (4.7%) were other etiologies. The prevalence of peripheral neuropathy by electrophysiological studies was found to be 67.39% in cirrhosis of any etiology, of which 43.5% had sensorimotor type and the predominant pattern of peripheral neuropathy was mixed axonal degeneration and demyelination. The peripheral neuropathy was significantly more (p=0.01) in child class C than other child classes. Prevalence of neuropathy had no significant difference (p=1.00) between alcoholic and non-alcoholic cirrhosis. No correlation was present with either serum vitamin B12 levels or blood glucose levels.Conclusions: Peripheral neuropathy is present in more than half of cirrhosis patients and is unrelated to etiology and nutritional status but related to the severity of cirrhosis.

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Section: Discussionsupporting

confidence: 44%

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

2017

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“…51,[54][55][56] Cirrhosis is associated with impaired glucose tolerance (GT) in more than 80% of the patients. 57,58 Overt diabetes is seen around 20% of cirrhotics. Insulin resistance is a feature in patients with liver cirrhosis in the absence of diabetes.…”

Section: Impact Of Diabetes As Risk Factor In Hepatocellular Carcinomamentioning

confidence: 99%

Risk Factors for Hepatocellular Carcinoma in India

Kar

2014

Journal of Clinical and Experimental Hepatology

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Hepatocellular carcinoma (HCC) is an important cause of death all over the world, more so in Asia and Africa. The representative data on epidemiology of HCC in India is very scanty and cancer is not a reportable disease in India and the cancer registries in India are mostly urban. 45 million people who are suffering from chronic Hepatitis B virus (HBV) infection and approximately 15 million people who are afflicted with chronic Hepatitis C virus (HCV) infection in India. HBV and HCV infection is considered an important etiologic factor in HCC. Positive association between HCC and consumption of alcohol where alcohol contribute as a cofactor for hepatotoxins and hepatitis viruses. Aflatoxin contamination in the diets, Hepatitis B virus infection and liver cirrhosis in Andhra Pradesh, India and direct chronic exposure to aflatoxins was shown to cause liver cirrhosis. Cirrhosis of liver of any cause lead to develop about 70%-90% of HCC. Aflatoxin interact synergistically with Hepatitis B virus (HBV)/Hepatitis C virus (HCV) infection which increase the risk of HCC. HBV infection, HBV infection with Aflatoxin exposure, viral infection and alcohol consumption leading to overt cirrhosis of the liver, alcohol consumption leading to cirrhosis of the liver with viral infection are the predominant risk factor for the development of HCC. HCV and alcohol are also associated with HCC in India. Indians develop diabetes at younger age, Asians have strong genetic susceptibility for type II diabetes. Diabetes mellitus is identified as a risk factor for HCC. Prevention of viral infection by universal vaccination against hepatitis virus, HCC surveillance program, preventing alcoholic liver diseases, fungal contamination of grains and ground crops to prevent basically Aflatoxin exposure are important measures to prevent liver diseases and HCC among those at risk. ( J CLIN EXP HEPATOL 2014;4:S34-S42)

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“…There is evidence of a bi-directional relationship between liver disease and T2DM. Both ALD and NAFLD appear to be risk factors for T2DM, and T2DM is a risk factor for more severe liver disease in people with ALD or NAFLD (1)(2)(3)(4)(5)(6). The increased risk of CVD, cancer and mortality among people with type 2 diabetes, compared to people without diabetes, is well known (7)(8)(9).…”

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confidence: 99%

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

et al. 2017

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OBJECTIVE To describe associations between alcoholic fatty liver disease (ALD) or non-alcoholic fatty liver disease (NAFLD) hospital admission and cardiovascular disease (CVD), cancer, and mortality in people with T2DM. RESEARCH DESIGN AND METHODSWe performed a retrospective cohort study using linked population-based routine data from the diabetes register, hospital, cancer and death records for people aged 40-89 years, diagnosed with T2DM in Scotland 2004-2013 who had one or more hospital admission records. Liver disease and outcomes were identified using International Classification of Diseases codes.We estimated hazard ratios from Cox proportional hazards models, adjusted for key risk factors (aHRs). RESULTS

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Clinical implications of hepatogenous diabetes in liver cirrhosis

Cited by 173 publications

References 29 publications

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

Study of prevalence and pattern of peripheral neuropathy in patients with liver cirrhosis

Risk Factors for Hepatocellular Carcinoma in India

Cardiovascular Disease, Cancer, and Mortality Among People With Type 2 Diabetes and Alcoholic or Nonalcoholic Fatty Liver Disease Hospital Admission

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