A STUDY OF CLINICAL, BIOCHEMICAL, SONOLOGICAL PROFILE OF HEPATIC STATUS IN TYPE 2 DIABETES MELLITUS IN TERTIARY CARE SETTING

Dr. V. Sravani; Dr S. Krishna Mohana Rao; Dr G. Swarnalatha Devi

Volume : IX, Issue : IX, September - 2019

A STUDY OF CLINICAL, BIOCHEMICAL, SONOLOGICAL PROFILE OF HEPATIC STATUS IN TYPE 2 DIABETES MELLITUS IN TERTIARY CARE SETTING

Dr. V. Sravani, Dr S. Krishna Mohana Rao, Dr G. Swarnalatha Devi

Abstract :

INTRODUCTION: The prevalence of diabetes is increasing world over and is expected to affect 57 million adults in India by 2025. Apart from kidney, eye, heart and blood vessels, liver is also indirectly related with diabetes mellitus. Virtually the entire spectrum of liver disease is seen in patients with type 2 diabetes. This includes abnormal liver enzymes, non alcoholic fatty liver disease (NAFLD), cirrhosis, hepatocellular carcinoma, and acute liver failure. In addition, there is an unexplained association of diabetes with hepatitis C. Finally, the prevalence of diabetes in cirrhosis is 12.3–57% . Thus, patients with diabetes have a high prevalence of liver disease and patients with liver disease have a high prevalence of diabetes. AIM OF STUDY : This study aims to describe clinical, biochemical, sonological profile of hepatic status in type 2 diabetes mellitus in tertiary care setting in relation with non alcoholic fatty liver disease (NAFLD) . MATERIALS AND METHODS: This study was done at ASRAM medical college Eluru between March 2018 and Feuary 2019. Sample size : 118 Inclusion criteria : Type 2 diabetic patients diagnosed according to the American Diabetic Association criteria, newly diagnosed or on follow– up were included in the study. Exclusion criteria 1.Patients with history of any chronic drug intake other than oral hypoglycemic drugs 2. Jaundice 3.History of alcohol intake 4.HBsAg positive. DISCUSSION: Since clinical symptoms of fatty liver are nonspecific or silent this study does not attempt to define the clinical symptoms of fatty liver. Fatty liver most commonly affects middle–aged women with obesity, altered glucose metabolism, hyperlipidemia, and hypertension. RESULTS: A total of one hundred and eighteen patients were included in the study, 71(60.2%) females and 47(39.8%) males. Eleven (9.3%) cases were newly diagnosed during the course of the study. Sixty six (55.9%) cases had diabetes for duration less than 5 years. Forty one (34.7%) cases had diabetes for a duration more than or equal to 5 years. CONCLUSIONS: The increasing prevalence of fatty liver in diabetes is well established. It is important to acknowledge that the increased incidence of steatohepatitis and hepatic fiosis in type 2 diabetes may translate into increased incidence of hepatocellular carcinoma. Liver biopsy though the gold standard for the diagnosis and staging of the disease, cannot be used for large scale screening.