Diabetes Mellitus Due to Liver Cirrhosis in 33-Year-Old Female

• Published in: The Indonesian journal of gastroenterology, hepatology, and digestive endoscopy (Jakarta) Vol. 14; no. 2; p. 117
• Main Authors: Tan, Henny Tanadi, Ndraha, Suzanna, Fabiani, Helena, Wician, Fendra, Santoso, Mardi, Tendean, Marshell
• Format: Journal Article
• Language: English
• Published: Jakarta Universitas Indonesia / University of Indonesia 01.08.2013
• Subjects: Anemia; Chronic illnesses; Diabetes; Glucose; Hepatitis; Interferon; Liver cirrhosis
• ISSN: 1411-4801; 2302-8181
• DOI: 10.24871/1422013117-119

Impaired glucose metabolism can occur in patient with chronic liver disease, either it is impaired glucose tolerance or diabetes mellitus (DM). DM due to liver cirrhosis is known as hepatogenous diabetes (HD). HD is different from type 2 DM in clinical signs and management. A 33-year-old female came with chief complaint of fatigue since three days before admission. Patient also complained of nausea, vomiting, and increased abdominal circumference since one year ago. Patient was diagnosed with DM two months ago. From physical examination, anemic and ascites without signs of cirrhosis were obtained. Laboratory test showed mild anemia with hemoglobin levels 6.5 g/dL, elevated serum bilirubin and liver enzymes, decreased serum albumin, prolonged prothrombin time and elevated random blood glucose. Serologic test showed chronic hepatitis B with HBV DNA 1.61 x 104 copy/mL. The abdominal ultrasound result showed liver cirrhosis with ascites. The patient was diagnosed with hepatogenous diabetes in liver cirrhosis due to chronic hepatitis B infection and anemia of chronic disease. The management of this patient was quite complex especially in administration of oral antidiabetic agent which could affect the liver function.