Does type 1 diabetes cause liver problems?
According to the findings given at The Liver Meeting,
patients with type 1 diabetes had a fourfold higher chance of developing
chronic liver disease, including cirrhosis, than the general population.
Scientists in the United Kingdom used a computer database to
identify 57 (1.2 percent) patients with type 1 diabetes who had undergone 82
liver biopsies from a longitudinal cohort of 4,644 people with the disease.
Insulin-treated (n=57) and non-insulin-treated type 2 diabetic patients (n=57)
were gender-matched. Both groups of people with type 2 diabetes had their
livers biopsied.
301 liver biopsies were performed on 270 participants (2.8
percent) in the type 2 diabetes cohort (n=9,571). Type 1 diabetes patients had
a lower rate of nonalcoholic fatty liver disease (OR=0.35; 95 percent CI,
0.15-0.82) than both type 2 diabetes groups, but they had a greater rate of
glycogenosis diagnosis (OR=9.1; 95 percent CI, 1.10-75.75).
During the study's follow-up, 14 type 1 diabetes patients
were diagnosed with cirrhosis, resulting in a prevalence of at least 301.5
(170-520) per 100,000 people, compared to a cirrhosis prevalence of
76.3/100,000 (OR=3.96; 95 percent CI, 2.24-7.01) in the general UK population.
Type 1 diabetics had a lower cirrhosis diagnosis rate than type 2 diabetics who
used insulin (OR=0.46; 95 percent CI, 0.23-0.91) and type 2 nonusers (OR=0.42;
95 percent CI, 0.21-0.84).
Twenty-two type 1 diabetes patients (38.6%) died throughout
follow-up, resulting in a crude mortality rate of 6,539/100,000 person-years,
compared to 1,878/100,000 person-years predicted by the National Diabetes
Mortality Analysis 2007-08.
David J. Harman, PhD, hepatology research fellow at
Nottingham Digestive Diseases Centre Biomedical Research Unit in England, told
Healio.com, "A patient with type 1 diabetes is at a substantial risk of
having liver disease, and I don't think it was something that was previously
acknowledged." "To corroborate this findings and develop new algorithms
to develop type 1 diabetes, prospective cohorts are required." But I
believe this is the first step toward establishing that they, like their type 2
diabetes counterparts, are at high risk of liver damage."
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