LIVER-CIRRHOSIS IN TYPE-II DIABETIC-PATIENTS DOES NOT WORSEN INSULIN-RESISTANCE

This study aimed at evaluating the effect of liver cirrhosis on insuli n resistance in normal- and over-weight patients with Type II diabetes mellitus. Investigations were carried out in 4 groups of Type II diab etic patients in secondary failure to oral hypoglycemic agents: 6 norm al-weight patients with no liver dysfunction (D), 6 normal-weight pati ents with post-hepatitic (by virus B or C) liver cirrhosis (CD), 6 ove r-weight patients with no liver dysfunction (OD), 6 over-weight patien ts with post-hepatitic (by virus B or C) liver cirrhosis (OCD). All pa tients were submitted to glucagon test (1 mg intravenously) and euglyc emic hyperinsulinemic clamp (0.1 U . kg(-1). hr(-1)). Glucagon test: T he areas under the curves of plasma glucose (60 min after stimulus) an d C-peptide (first 15 min after stimulus) were similar in all groups. Euglycemic clamp: No significant difference in glucose requirements (M values) among the groups was found. Steady state plasma insulin (SS-I RI) concentrations resulted significantly lower (p<0.02) and insulin s ensitivity index (M/SS-IR X 100) significantly higher (p<0.0001) in no rmal-weight (D + CD) than in over-weight (OD + OCD) diabetic patients. No statistically significant difference was found in non-cirrhotic (D + OD) vs cirrhotic (CD + OCD) diabetic patients for the same paramete rs and no interactive effect of both obesity and cirrhosis on insulin resistance were found. The coexistence of liver cirrhosis, as opposed to obesity, does not worsen the insulin resistance in Type II diabetic patients. The defects in insulin-mediated glucose metabolism inherent to Type II diabetes probably mask those induced by liver cirrhosis.