Impact of Diabetes on the Severity of Liver Disease

[Guest guest]

Impact of

Diabetes on the Severity of Liver Disease

Ingrid J. Hickman PhD and Graeme A.

Macdonald MBBS, PhD

aDiamantina

Institute for Cancer, Immunology and Metabolic Medicine, Princess

andra Hospital,

Brisbane, Queensland, Australia

bDepartment of

Gastroenterology and Hepatology, Princess andra Hospital, Brisbane,

Queensland, Australia.

Available online 27 September 2007.

Abstract

The

prevalence of type 2 diabetes is higher in patients who have liver diseases,

such as nonalcoholic fatty liver disease, chronic viral hepatitis, hemochromatosis, alcoholic liver disease, and cirrhosis. The development of diabetes in patients with cirrhosis is

well recognized, but evidence is emerging that the development of chronic liver

disease and progression to cirrhosis may occur after the diagnosis of diabetes

and that diabetes plays a role in the initiation and progression of liver

injury. This article provides an overview of the

evidence for an increased prevalence of diabetes in a range of liver diseases;

the effect of diabetes on the severity of disease; the potential mechanisms

whereby coexistent diabetes exacerbates progression of hepatic fibrosis; and

the impact of obesity, insulin resistance, and type 2

diabetes on clinical outcomes.

With love, Barb in Texas - Together in the Fight, Whatever it Takes!

Son Ken (33) UC 91 - PSC 99 - Tx 6/21 & 6/30/07 @ Baylor in Dallas

[Guest guest]

This is very interesting to me. Noah has had major hypoglycemic issues

which make me concerned for the diabetes issue. I know he can't go

long without food and this is something that Pitt has had a hard time

nailing down as far as how to treat it or what to do. They want to

catch it in the acute phase but how long do you really want to let him

be there shaking and near passing out? I don't know how this would get

diagnosed and if hypoglycemia would have any bearing on whether or not

he would end up with diabetes. How do you treat it? I think we have

been doing wht they would do. keep quick sugar on hand.

Any ideas? Thoughts?

[Guest guest]

I don't really think that hypoglycemia should lead to diabetes since

hypoglycemia is a condition in which blood glucose levels drop too

low. Diabetes, however, is a condition in which the body either cannot

produce insulin or cannot effectively use the insulin it produces. So

I'd think that hypoglycemia results from either an over production of

insulin or an increased sensitivity to it. [Help me out folks that are

more knowledgeable on this.]

From my own experience, I would suggest having Noah eat more

frequently during the day but keeping the meals small rather than

charge his body with too much quick sugar. Although, when necessary,

that always works when there's nothing else and he really needs it.

Meals (all-day grazing really) are better to contain a mix of carbs

and proteins with the carb source being both high and low glycemic

index. This does require some planning as far as the day's meals are

concerned but in the long run, it's worth the effort.

[Guest guest]

What you say makes complete sense. I guess what I have in the back

of my mind is " Steel Magnolias " ... you remember where

is getting her hair done for her wedding and her sugar dives (I

assume... they gave her candy and juice.)?

The other thing in the back of my head is the relationship with the

pancreas and the liver and how I know some here have actually said

they would possibly need a pancreas transplant too... or to be put

into a state of diabetic-ness...if that is a word.... and then to

take the shots for the rest of their lives. I am probably taking

pieces of the picture...

I guess I just know how quickly he runs out of steam too. If and

when he ever gets a virus like the other two have... he is hospital

bound without a doubt. He must have no stores. He has to be hooked

up to an IV. That has happened twice in the last year. He vomits

bile unrelentingly... and they have to give IV Zofran to get him to

stop. EW!! Let's hope for a quiet season.

I hope you are feeling well .

Blessings,