[Liver cirrhosis and diabetes mellitus]

Statistically there exists an increased coincidence between liver cirrhosis and diabetes mellitus. The higher frequency of cirrhosis in diabetics compared with the normal population is to be explained partly from the higher risk of hepatitis. In addition to this the diabetic suffers from disturbances which further the development of cirrhosis, such as fatty degeneration of the liver, abuse of alcohol, more frequent inflammatory diseases of the bile duct and others. When a diabetes mellitus exists in liver cirrhosis it is to be differed between a diabetes due to absolute or relative insulin deficit and disturbances of carbohydrate clearance which are associated with normal or increased insulin levels. The latter form can be denoted as so-called liver diabetes. Main cause of this carbohydrate intolerance is an insulin resistance, partly by deminution of the metabolically active liver parenchyma, partly by the diminished reactivity of the peripheral tissues. By prophylactic measures and differentiated therapy may be favourably influenced lesions of the liver in diabetes mellitus as well as disturbances of the carbohydrate metabolism.