A Cross-Sectional Study on Occurrence of Type 2 Diabetes among Patients Admitted with Chronic Liver Diseases in a Medical College in Kolkata

Objectives: To study the magnitude of the problem of type 2 diabetes mellitus and impaired glucose intolerance among the patients with various types of chronic liver diseases and to fi nd out the association of diabetes mellitus and impaired glucose tolerance with the demographic and clinical characteristics of the patients. Materials and Methods: This observational study, which was cross-sectional in design, was undertaken in the Department of General Medicine at a medical College in Kolkata during October 2010 to July 2011. Altogether 161 patients diagnosed with chronic liver disease (CLD) were admitted in the General Medicine ward during the study period, out of which 9 patients got themselves discharged against medical advice. From the remaining 152 patients, a total of 136 patients aged 20 years and above were selected for the study according to the inclusion criteria. A detailed history was taken, and a thorough clinical examination was done followed by further investigations, all of which were recorded in a pre-designed, structured proforma. Results: Among the study subjects, 58.1% had impaired glucose tolerance (IGT), while 14.0% had overt diabetes mellitus. IGT and diabetes were signifi cantly higher among the CLD patients aged 45 years or more (P < 0.05). However, similar association was not observed with regard to sex of the patients. No association was found between the occurrence of IGT and/or overt diabetes with either severity (as per Child-Pugh score) or with the duration of CLD. More than half of the study subjects having alcoholic liver disease or chronic hepatitis B or C or autoimmune hepatitis and one third of those having Wilson’s disease had IGT, while one third of those with either chronic hepatitis C or Wilson’s disease and one fourth of those having autoimmune hepatitis had overt diabetes. Twenty-one percent of those with chronic hepatitis B also found to have overt diabetes, which was least in those with alcoholic liver disease. However, the overall glycemic status had no signifi cant relation with the etiology of CLD. Conclusion: It can be concluded that the occurrence of diabetes and IGT could be a matter of great concern in CLD patients, indicating towards the need for regular monitoring of the glycemic status in these patients, which would have a defi nite bearing upon the treatment strategy.