Acute Variceal Bleeding in Patients with Liver Cirrhosis with and without Diabetes

Abstract

Objectives: To study the effect of diabetes mellitus on presentations, course, and outcome of 
acute variceal bleeding in cirrhotic patients.
Methods: We compared 2 matched groups of patients, a diabetic group and non-diabetic group, 
where all of the patients presented with acute esophageal varices due to liver cirrhosis. All patients underwent history taking, clinical examination, emergency treatment, upper endoscopy, 
laboratory investigations and abdominal ultrasound; they followed up until hospital discharge.
Results: The diabetic group showed statistically significant unstable course in 73.3% of them 
compared to 36.6% in the control; more attacks of melena (2.2±1.03) compared to control 
(1.7±0.88), and also had significantly disturbed level of consciousness compared to control 
(36.7% versus 10% respectively); moreover they have significantly more right and left lobe 
enlargement than control (70% versus 26.7%, and 66.7 versus 40% respectively), significantly 
more echogenic liver (70% versus 33.3), highly significant more portal vein dilatations (73.3% 
versus 16.7%) and highly significant more collaterals (50% versus 23.3%); the splenic size was 
also significantly more enlarged in diabetics (60%) than control (40%), and the splenic vein diameter was significantly more dilated in diabetics (33.3%) versus control group (6.7%); finally 
the mortality was more in the diabetic group.
Conclusions: Diabetic patients with acute variceal bleeding may show more morbidity and 
mortality rates.