Liver has a pivotal role in glucose homeostasis and maintaining blood glucose values within strict normal limits. Chronic liver disease results in impaired glucose tolerance and diabetes, resulting in the entity called Hepatogenous Diabetes. The aetiology as well as the severity of hepatocellular dysfunction has a significant effect on carbohydrate metabolism. The reported incidence of glucose intolerance and diabetes in different studies varies from as low as 20% to as high as 80%. As the liver function worsens, diabetes manifests clinically, and thus Hepatogenous diabetes can be considered a marker of advancing liver disease. The underlying mechanisms are ill-understood. The influence of other extraneous factors like infections, old age, medications and other systemic diseases might also influence the glycemic status. Despite these findings, little attention has been paid on understanding the full spectrum of glycemic dysfunction in our population. This study on 169 patients with chronic liver disease was undertaken to clarify the frequency of occurrence of impaired glucose tolerance, with emphasis on the effect of aetiology and severity of liver dysfunction. This study concluded that of all the causes of chronic liver disease, cirrhosis was most frequently associated with impaired glucose tolerance, next being Hepatitis C(compared to Hepatitis B). Higher incidence was also noted in Child Pugh’s A grading of severity, alcoholism and in the male gender patients. However, our study was limited by the lack of liver biopsy in all patients, with the diagnosis of cirrhosis resting on USG findings.

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Dr Rashmi KP

Govt TD Medical College, Alleppey, Kerala