[Diabetes mellitus in chronic alcoholic liver damage]

We performed an oral glucose tolerance test and measured serum insulin levels in 38 patients with chronic alcoholic liver damage. A diabetic curve was obtained in 34% of subjects both obese and non obese. Insulin levels were elevated in comparison with normal subjects in all patients. The Turner index [(serum insulin x 100)/(blood sugar--30]) was lower than normal at all points of the GTT, suggesting a decreased insulin secretion in relation to serum glucose level. Blood glucose level at 120 min was correlated to age, serum bilirubin and prothrombin time. Thus, chronic liver damage is a risk factor for diabetes mellitus. The alteration of carbohydrate metabolism is correlated to the severity of liver disfunction. The initial pathogenic factor may be hyperinsulinism and resistance to insulin, followed by decreased secretion of the hormone.