DIABETES AND CIRRHOSIS: PREVALENCE AND IMPACT
Tlili Raja*, Kchir Hela, Ayadi Rahma, Hassine Hajer and Maamouri Nadia
Background: Abnormalities of glucose metabolism are common in cirrhosis. About 31% of cirrhotic patients have diabetes. Diabetes appears both as a consequence of cirrhosis and as an aggravating factor of its clinical course. Aim: The aim of the current study was to determine the prevalence of diabetes during cirrhosis and compare virological profile, as well as the severity of cirrhosis and its evolutionary modalities according to the prescence or not of diabetes. Methods: To meet these objectives we conducted a descriptive and retrospective study, including all patients followed for cirrhosis in the gastroenterology department B of the Rabta hospital in Tunisia. Patients were divided into 2 groups according respectively to presence or not of diabetes. Results: One hundred and thirty-two patients were included. Among the study population, 40.9% had diabetes. In uni-variate analysis, our results showed that liver disease was more severe in diabetic cirrhotics. In addition, complications of cirrhosis were significantly associated with diabetes, such as ascites, hepatic encephalopathy, esophageal variceal hemorrhage, hepatocellular carcinoma and infections. In multivariate analysis, same factors were associated with diabetes in cirrhosis except ascites and hepatic encephalopathy. Conclusions: Through this study, our results confirm that diabetes seems to worsen the evolutionary course of cirrhosis. Therefore, modalities of monitoring and management of a cirrhotic patient must be reconsidered in the presence of diabetes.
Keywords: Diabetes, cirrhosis, hepatocellular carcinoma, prognosis, complications.
[Full Text Article]