Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 9
Abstract
Introduction: Cirrhosis of the liver and diabetes mellitus are two chronic illnesses with significant impact on the quality of life. Studies from different part of the world have shown the combination to be associated with higher incidence of complications of cirrhosis and reduced survival. However, data on the impact of pre-cirrhotic and post-cirrhotic diabetes on cirrhosis is minimal. Aim: The aim of the study was to determine the complications of cirrhosis patients with and without co-existent DM and to compare the relation between cirrhosis patients with antecedent DM and hepatogenous DM. Materials and Methods: The present prospective study was conducted at a tertiary care hospital in Kerala, India, over a period of three years. Cirrhosis patients with and without diabetes, along with subcategorization as antecedent and hepatogenous diabetes, were studied for various complications and outcome including death. Chi-square and Mann-whitney tests were used for comparing data. Results: Patients with cirrhosis and diabetes had higher incidence of gall stones (27.6% versus 13.2%; p=0.008) and urinary infection (29.3% versus 7.5%; p=<0.001). Incidence of hepatocellular carcinoma and mortality were similar between the groups. Patients with antecedent diabetes and hepatogenous diabetes were similar with respect to complications and mortality. Child-Turcotte-Pugh (CTP) score, Model for End stage Liver Disease (MELD) score, urinary tract and respiratory infections and duration of cirrhosis were independent predictors of mortality in patients with cirrhosis. Conclusion: Coexistent diabetes mellitus increases the incidence of complications and hospitalizations in cirrhosis patients but without impact on mortality rates. There is no significant morbidity or mortality difference between cirrhotics with antecedent diabetes and hepatogenous diabetes.
Authors and Affiliations
Thazhath Mavali Ramachandran, Aninchent harayil Rajan Rajneesh, George Sarin Zacharia, Rajendran P Adarsh
Keywords
Related Articles
- EP ID EP362979
- DOI 10.7860/JCDR/2017/30705.10529
- Views 95
- Downloads 0
Root Conditioning with Citric Acid and Ethylenediaminetetraacetic Acid and their Effect on Fibrin Clot Adhesion to Dentin-A Scanning Electron Microscopic Study
Introduction: Root biomodifiers are used to remove the smear layer formed on the roots as a result of mechanical debridement and also to expose collagen fibers making the root surfaces biologically acceptable. Further, t...
A Prospective Observational Study to Compare the Efficacy and Adverse Effects of Glimepiride and Vildagliptin Added to Metformin in Type 2 Diabetes Mellitus
ABSTRACT Introduction: In order to prevent the specific diabetes mellitus related macrovascular and microvascular complications, guidelines by American Diabetes Association recommend a reasonable glycosylated haemoglobin...
The Association between Periodontal Status, Serum Lipid Levels, Lipoprotein Associated Phosholipase A2 (Lp-PLA2) in Chronic Periodontitis Subjects and Healthy Controls
Introduction: Lipoprotein associated phospholipase A2 (Lp-PLA2) has been explored as a potential biomarker for Cardiovascular Disease (CVD). The human Lp-PLA2 is a serinedependent, Ca2+- independent enzyme. It gives way...
Herbs in Oral Mucositis
Oral mucositis is an inflammatory mucosal destruction as a result of chemotherapy and/or radiation therapy, which in severe cases can impair patients’ quality of life. Moreover, mucosal infection and/or systemic involvem...
Mandibular Lingual Concavity: A Cross-sectional Analysis using Cone Beam Computed Tomography
ABSTRACT Introduction: Cross-sectional analysis using Cone Beam Computed Tomography (CBCT) is appropriate for assessment of lingual undercuts and prevention of lingual cortex perforation and subsequent complications. A...