Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?

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. Howe...

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Main Authors: Thazhath Mavali Ramachandran, Aninchent Harayil Rajan Rajneesh, George Sarin Zacharia, Rajendran P Adarsh
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2017-09-01
Series:Journal of Clinical and Diagnostic Research
Subjects:
Online Access:https://jcdr.net/articles/PDF/10529/30705_CE[RA1]_F[AP]_PF1(NE_VT_GG)_PFA(NE_SS).pdf
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author Thazhath Mavali Ramachandran
Aninchent Harayil Rajan Rajneesh
George Sarin Zacharia
Rajendran P Adarsh
author_facet Thazhath Mavali Ramachandran
Aninchent Harayil Rajan Rajneesh
George Sarin Zacharia
Rajendran P Adarsh
author_sort Thazhath Mavali Ramachandran
collection DOAJ
description 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.
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spelling doaj.art-fe4b0e9a80fe494f8d33427092c3ac5a2022-12-22T03:07:07ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2017-09-01119OC01OC0510.7860/JCDR/2017/30705.10529Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?Thazhath Mavali Ramachandran0Aninchent Harayil Rajan Rajneesh1George Sarin Zacharia2Rajendran P Adarsh3Additional Professor, Department of Medical Gastroenterology, Government Medical College, Kozhikode, Kerala, India.Senior Resident, Department of Medical Gastroenterology, Government Medical College, Kozhikode, Kerala, India.Senior Resident, Department of Medical Gastroenterology, Government Medical College, Kozhikode, Kerala, India.Senior Resident, Department of Medical Gastroenterology, Government Medical College, Kozhikode, Kerala, India.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.https://jcdr.net/articles/PDF/10529/30705_CE[RA1]_F[AP]_PF1(NE_VT_GG)_PFA(NE_SS).pdfcarcinomacomplicationshepatocellularurinary tract infection
spellingShingle Thazhath Mavali Ramachandran
Aninchent Harayil Rajan Rajneesh
George Sarin Zacharia
Rajendran P Adarsh
Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
Journal of Clinical and Diagnostic Research
carcinoma
complications
hepatocellular
urinary tract infection
title Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
title_full Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
title_fullStr Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
title_full_unstemmed Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
title_short Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?
title_sort cirrhosis of liver and diabetes mellitus the diabolic duo
topic carcinoma
complications
hepatocellular
urinary tract infection
url https://jcdr.net/articles/PDF/10529/30705_CE[RA1]_F[AP]_PF1(NE_VT_GG)_PFA(NE_SS).pdf
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AT georgesarinzacharia cirrhosisofliveranddiabetesmellitusthediabolicduo
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