Cirrhosis of Liver and Diabetes Mellitus: The Diabolic Duo?Correspondence Address :
Dr. Thazhath Mavali Ramachandran,
Additional Professor, Department of Medical Gastroenterology, Government Medical College, Kozhikode-673008, 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: This was a prospective study 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/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.
Carcinoma, Complications, Hepatocellular, Urinary tract infection
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 [serial online] 2017 September [cited: 2017 Nov 21 ]; 11:OC01-OC05. Available from
Date of Submission: Jun 05, 2017
Date of Peer Review: Jun 21, 2017
Date of Acceptance: Aug 08, 2017
Date of Publishing: Sep 01, 2017
FINANCIAL OR OTHER COMPETING INTERESTS: None.
- PubMed Central® (PMC)New
- Academic Search Complete Database
- Chemical Abstracts Service
- Directory of Open Access Journals (DOAJ)
- Embase & EMbiology
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Open J-Gate
- Popline (reproductive health literature)