Two types of diabetes are usually seen in patients with cirrhosis: type 2 diabetes mellitus and hepatogenous diabetes (HD). The HD is an. Download Citation on ResearchGate | Hepatogenous diabetes: Pathophysiology, therapeutic options and prognosis | About 80% of patients with chronic liver. A literature search was conducted in different databases to study the topic of liver problems and diabetes. The aim of the study was to explore more about an.
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August 29, ; Accepted date: November 25, ; Published date: Hepatogenous Diabetes Mechanism and Some Evidences. J Cell Sci Ther 7: This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
A literature search was conducted in different databases to study the topic of liver problems and diabetes. The aim of the study was to explore more about an association of diabetes mellitus with the liver. The study shows that diabetes does indeed have an effect on liver. Similarly, liver problems like chronic liver disease lead to diabetes which is known as hepatogenous diabetes.
Common liver problems seen in diabetes patients include but not limited to fatty liver, decreased glycogen levels, risk of liver cancer etc. Like any medical problem, any knowledge about any subject is never enough, therefore we recommend more studies in the near future to broaden hepatogenoud understanding bepatogenous the association of the liver with diabetes.
Diabetes; Diabetes complications; Diabetes and liver; Diabetes and fatty liver; Diabetes and hepatogenos Diabetes and cirrhosis. I do have diabetes and I have been compliant with my medication, but now I have this epigastric pain….
It can make the management of such patient difficult if the clinician is not aware that there is an association of diabetes with liver. This short review is our attempt to highlight the possible association between the diabetes type- 1, type-2 and liver.
Diabetes mellitus is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or due to insulin resistance when cells do not respond to the insulin that is produced [ 1 ]. The resultant high blood sugar produces the classical symptoms of polyuria, polydipsia and polyphagia.
Diabetes mellitus can be Type 1 DM, which results from autoimmune destruction of insulin-producing beta cells of the pancreas or of Hepatogenoys 2 He;atogenous, which begins with insulin helatogenous and relative insulin deficiency [ 23 ]. There hepatogenouw various complications due to Diabetes which can be divided into two types. Microvascular complications include Diabetic retinopathyDiabetic nephropathy and Diabetic neuropathy.
Similarly, macrovascular complications dizbetes atherosclerosis, coronary heart disease, heparogenous cerebrovascular disease etc. In this mini review, we will highlight the topic about the association of liver diseases with diabetes mellitus. The published data is sufficient to show that there is a possible association between the two. Sometimes liver problems lead to diabetes mellitus, while sometimes diabetes affects liver.
We hope that this article will be helpful for young scientist and physicians interested in this aspect of endocrinology and gastroenterology. The article will be comprised of a method section, followed by the discussion. In the discussion, we will highlight the possible heatogenous problems with diabetes type 1 and 2. The review will be concluded with the findings that there is indeed an association between liver problems and pancreatic problems like diabetes.
However, the association of liver cancer with diabetes remain dubious due to mix findings and conflicting results of some studies.
Therefore, we will recommend future studies on the subject to bring more details for the diabetez readers. The research methodology involves hepatogdnous relevant abstract, papers and reviews from different publications and journals in PubMed, Wiley, Elsevier, Google Scholar, and others without any date restriction. The literatures gathered were pertinent to types, complications and liver based effects of Diabetes. Keywords for the review included: Diabetes, Diabetes complications, Diabetes and liver, Diabetes and fatty liver, Diabetes and hepatitis, Diabetes and cirrhosis.
Each abstract was evaluated through determination of the relevance on the research review. After reviewing over two hundred hepatogenoys fifty abstracts and articles, the relevant ones were chosen for inclusion on the final paper.
The focus was made on the subject of Diabetes and its effects on liver. The data was hpeatogenous from different research projects, experiments, journals, systematic reviews, mini reviews, and case series.
Therefore, the following inclusion and exclusion criteria were selected. The inclusion criteria included, the articles published about the subject of the association of liver and diabetes mellitus were selected. The articles published after the year after selected to keep the literature updated with a combination of old and new literature.
The articles strictly about human studies and clinical trials were included. While the exclusion criteria included, the articles with vague or no clear findings were excluded.
Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?
According to Consoli et al. There was also a correlation with fasting blood glucose. In the same study, a new isotopic approach was applied for determination of contributions by gluconeogenesis and glycogenolysis through infusions of [H] glucose and [C] acetate.
Hepatogenkus approach dizbetes applied in 14 post-absorptive NIDDM patients and in nine healthy subjects same age and weight to trace overall hepatic glucose output and phosphenol pyruvate gluconeogenesis. The finding of this hepatogejous was that the overall diahetes output was increased by 2 times in NIDDM patients while there was three-fold raise in phosphenol pyruvate glucogenesis. In the patients suffering with acute diabetes, Glycogen synthesis is affected. The liver glycogen during post bepatogenous and post hour fast state was calculated in streptozotocin STZ -diabetic rats by Ferranini et al.
The short term diabetic animals were hepagogenous to have reduced liver glycogen levels in post prandial state. However, this was not true for long term diabetic rats. There was a reduction in hepatic glycogen in acute diabetes during fasting but increased in chronic diabetes. The liver glycogen synthase percentage in active form synthase a was seen less hepatogenohs normal in short term diabetic and old nondiabetic rats.
However, there was a remarkable increase in long term diabetic animals [ 6 ]. Hence, some patients with brittle diabetes mellitus experience increased liver glycogen levels due to wide variations in blood sugar and frequent doses of soluble insulin but not due to enzyme deficiency [ 7 ].
The association of diabetes with fatty liver is well documented [ 8 ]. A particularly interesting suggestion was made by Bogoch et al.
They suggested that humans possess same dynamic change in hepatogenou lipids as experimental animals. The neutral fats are most involved during the accumulation of lipids in the diabetic liver. The degree of fatty metamorphosis of liver was not observed to be directly correlated with any other histochemical or laboratory observations. A suggestive correlation between marked increases of lipids and hepatomegaly was seen among the diabetes patients [ 9 ].
A study in diabetic hepatitis by Nagore et al. There are other studies performed to observe the relation of fatty liver with diabetes [ 1112 ]. Perisinusoidal fibrosis is also common in the liver of type I diabetic patients. A study by Bernau et al. A study was performed in maturity onset diabetic patients with hepatomegaly, which showed collagen surrounded swollen hepatocytes containing intracellular hepatogenoks without presence of polymorphonuclear neutrophils and regenerating nodules [ 13 ].
We have discussed some liver alterations caused by diabetes, or some liver problems prevalent in diabetic patients. However, when a chronic liver disease leads to diabetes, this condition is known as hepatogenous diabetes HD.
Not much has been written about it. Yet some studies exist that describe the exact diabete mechanism of this disease.
Insulin resistance is thought to be the culprit leading to hepatogenous diabetes. Eventually leading to B-cell exhaustion. Diabeges, developing diabetes [ 1415 ].
The mechanism how insulin resistance ensues, involves portosystemic shunts and decreased overall liver mass. As a result, insulin clearance is impaired, hence leading to peripheral insulin resistance though down-regulation of insulin receptors. Augmented levels of advanced-glycation-end products and hypoxia-induciblefactors are also involved in the pathophysiology of hepatogenous diabetes [ 16 ].
In addition, TCF7L2 polymorphisms also considered to be possible cancer risk are also found associated with HD [ 18 ]. In a study by Kawaguchi et al. The study suggested that hepatogenous diabetes is caused due to increased insulin resistance which is often associated with chronic liver disease. Gepatogenous factors responsible for development of hepatogenous diabetes are hepatic parenchymal cell damage, portal systemic shunting and Hepatitis C virus infection.
Hepatogenous diabetes: Is it time to separate it from type 2 diabetes?
Liver failure, hepatocellular carcinoma and gastrointestinal hemorrhage are the major causes of death in cirrhotic patients with diabetes. The exogenous insulin or sulfonylureas may promote hepatocarcinogenesis in the patient with hepatogenous diabetes. The hepatogenous diabetes differ from lifestyle-related type 2 diabetes in its pathogenesis, cause of death, assessment, and therapeutic strategy [ 18 ].
There are other studies conducted about Hepatogenous diabetes [ 19 – 37 ]. Another subject of investigation has been on solving the dilemma on prior occurrence of liver disease or diabetes. Studies from Hickman et al suggest that development of chronic liver disease and cirrhosis occurs after diabetes and diabetes is the factor to initiate and develop the liver injury [ 38 ]. The American Diabetes Association do not yet recognize Hepatogneous Diabetes [ 39 ], and no treatment has been proposed officially for the problem.
However, liver transplant has been described as a successful mode of treatment in one study [ 4041 ]. Therefore, it is premature to suggest or comment on a possible best treatment for HD Figure 1 and Table 1. The Flow chart showing the cyclical nature of the association of diabetes with liver. The pancreatic damage leads to diabetes and that eventually leads to liver problems like fatty liver eventually leading to cirrhosis.
However, in hepatogenous diabetes, the chronic liver disease cirrhosis leads to pancreatic damage because of insulin resistance compensation. Both hepatitis patients and those with cirrhosis were found to acquire glomerulonephritis. Hepatitis C virus was more correlated with Glomerular injury compared with Hepatitis B virus. The study suggested that Hepatitis C virus may have direct role in development of diabetes [ 42 ].
According to Iovanescu et al. On the other hand, an association of hemochromatosis with diabetes is also studied by Adams et al. Therefore, this suggests an indirect association of diabetes with liver problems.