Hepatic encephalopathy in patients with diabetes mellitus

Shaheen, El-Saied; Elshazly, Helmy; Allah, Noha Abd

doi:10.4103/jmisr.jmisr_88_18

Cited by 2 publications

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“…However, these studies were of limited sample size and retrospective design. Thereafter, the current study was performed to overcome these limitations (18) .…”

Section: Discussionmentioning

confidence: 99%

Diabetes as a Risk Factor Hepatic Encephalopathy among Egyptian Cirrhotic Patients

El-Alfy

Dousoky

Shaheen

et al. 2019

The Egyptian Journal of Hospital Medicine

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Background: Hepatic encephalopathy (HE) is one of the leading consequences among patients with cirrhotic liver, which influence more than 35% of these patients. It was established that more than 95% of cirrhotic patients were associated with glucose intolerance and approximately 33% of them had type 2 diabetes mellitus (DM). This investigation was conducted to evaluate the possible association between DM and the development of HE. Objective: this study was designed to examine the association of DM with the prevalence and severity of HE in Egyptian patients with decompensated cirrhosis. Patients and methods: This study was carried out prospectively on 100 patients presented with HE. Those further had been classified into diabetic (60 patients group 1) and non-diabetic (40 patients group 2). All patients in this study were subjected to a thorough assessment of history taking, thorough physical examination, laboratory investigations including complete blood picture, kidney and liver function tests, viral HBsAg and HCVAb, serum sodium, potassium, calcium and magnesium, serum ammonia levels, fasting and glycosylated hemoglobin (HbA1C %) and abdominal ultrasonography. Results: Diabetic patients showed a higher incidence of Grades, III, and IV of HE compared to the non-diabetic group with p value < 0.0001 for each grade. Furthermore, there was a statistically significant difference between both groups regarding the Child-Pough classification. A statistically significant positive correlations between fasting blood sugar level, and glycosylated hemoglobin with HE grades (r = 0.430 and p =0.0006), (r = 0.314, p = 0.0145) respectively among diabetic patients group 1. Conclusions: Egyptian diabetic patients have a potential risk of developing HE among cirrhotic liver patients relative to non-diabetic patients.

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“…However, these studies were of limited sample size and retrospective design. Thereafter, the current study was performed to overcome these limitations (18) .…”

Section: Discussionmentioning

confidence: 99%

Diabetes as a Risk Factor Hepatic Encephalopathy among Egyptian Cirrhotic Patients

El-Alfy

Dousoky

Shaheen

et al. 2019

The Egyptian Journal of Hospital Medicine

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“…Shaheen et al found patients with cirrhosis with long-standing and uncontrolled DM are more likely to develop HE. Autonomic neuropathy, which may complicate patients with cirrhosis with long-standing uncontrolled diabetes, may play a role in the pathogenesis of HE in these patients[16].Ghada et al found diabetic patients had a higher frequency of all grades of HE mean number of attacks for each patient in the past three months is 1.9±0.3 versus 0.8±0.1 in non-diabetics with unclear precipitating factor in 43% of diabetic patients versus 23% in non-diabetic patients. Patients on oral hypoglycemic drugs represented 14.3% of diabetic patients.…”

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confidence: 99%

Association of Type 2 Diabetes and Hepatic Encephalopathy in Chronic Liver Disease Patients

Usmani

Rahman

Jamal

et al. 2021

Cureus

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Background Hepatic encephalopathy (HE) is an important complication of hepatic cirrhosis and is an independent predictor of mortality in patients with cirrhosis. The prevalence of type 2 diabetes continues to increase at an alarming rate around the world, with even more people being affected by prediabetes. Diabetes leads to increased gastric transit and orocecal time, increased glutamase activity, and intestinal bacterial overgrowth, which may increase intestinal ammonia production. Thus, we speculated that diabetes mellitus (DM) might predispose cirrhotic patients to development and/or exacerbation of HE. The main purpose of this study is to determine the association of DM with severe HE in patients with chronic liver disease (CLD). Methods This case-control study (122 cases and 122 controls) was conducted for 6 months on patients who fulfilled the inclusion criteria and were selected from the Medical department, Abbasi Shaheed Hospital, Karachi, after taking informed consent. Demographic data were presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Chi-square was applied and the odds ratio (OR) was calculated taking a p-value of ≤ 0.05 as statistically significant. Results Out of a total of 244 patients, 122 patients had CLD with DM (case group) and 122 participants had CLD without DM (control group). The mean and standard deviation of age in the case and control groups in our study was 43.29±3.79 and 45.49±5.40. The mean and standard deviation of the duration of disease in the case and control groups in our study was 3.18±1.22 and 3.72±1.36. Males were 53 (43.44%) and 56 (45.10%) in the case and control groups, whereas females were 69 (56.56%) and 66 (54.10%) in the case and control groups, respectively. Out of 122 patients in the case group, 73 (59.84%) and 49 (40.16%) patients developed and did not develop severe HE, respectively. Out of 122 patients in the control group, 50 (40.98%) and 72 (59.02%) patients developed and did not develop severe HE, respectively. Binary logistic regression analysis showed an association of severe HE with DM (p-value: 0.93, OR: 1.033, 95% CI: 0.586-1.599). Conclusion This study demonstrates that HE is a common occurrence in CLD patients. There was not a direct relationship of DM with the severity of HE was observed. However, further research with larger sample size and involving a multicenter setting is warranted.

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Hepatic encephalopathy in patients with diabetes mellitus

Cited by 2 publications

References 1 publication

Diabetes as a Risk Factor Hepatic Encephalopathy among Egyptian Cirrhotic Patients

Diabetes as a Risk Factor Hepatic Encephalopathy among Egyptian Cirrhotic Patients

Association of Type 2 Diabetes and Hepatic Encephalopathy in Chronic Liver Disease Patients

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