Prevalence of Glucose Metabolism Disorder in Liver Cirrhosis and its Correlation with Risk Factors of Diabetes Mellitus: A Hospital-Based Cross Sectional Observational Study from New Delhi

ABSTRACT

Objectives: Association between liver cirrhosis (LC) and glucose intolerance has been known since long. This study was carried out to (1) determine the proportion of LC patients having insulin resistance and glucose metabolism disorder (GMD) which includes pre-diabetes (pre-DM) and diabetes mellitus (DM) and (2) study the correlation between GMD and the presence of risk factors (RF) for DM in patients with LC. Methods: 100 patients with LC admitted in medical wards were studied and tested with fasting plasma glucose (FPG), 2 hours post-75 gram oral glucose load plasma glucose (PPG), glycosylated hemoglobin (HbA1c) and fasting plasma insulin. They were also evaluated for the presence or absence of RF for DM and groups of LC patients with and without GMD were compared. Results: Out of the 100 patients, 77% were males and 76% were between 30-59 years of age. Insulin resistance (IR) was found in 26% and GMD in 39% (pre-DM 13% & DM 26%). Certain RF for DM like advanced age, positive family history (F/H) of DM, high body mass index (BMI), hypertension, high triglycerides, history of CAD/ CVA/ PVD showed positive correlation with the occurrence of GMD in LC; advanced age, hypertension and high triglycerides had a significant correlation with occurrence of IR. Conclusion: GMD was prevalent in about a third and IR in about a quarter of patients with LC. Traditional risk factors of DM increase the chances of an individual with LC having GMD. IR increased with advanced age, the presence of hypertension and high triglycerides and did not always predate GMD.