A Case of Improved
Insulin Resistance in Type 2 Diabetes After Liver Transplantation |
A Case of Improved Insulin Resistance in Type 2 Diabetes After Liver Transplantation |
Eugene Han; Nan Hee Cho; Ye Yeon Lee; Wang Yong Choi; In Wook Song; Ho Chan Cho |
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Abstract |
Recent studies have reported improvement of glycemic control following liver transplantation in
patients with type 2 diabetes mellitus and chronic liver disease, and yet, the underlying
mechanism is not well understood. In addition, the validity and effectiveness of such an approach
in treating type 2 diabetes have not been addressed in the literature, mainly due to the limited
amount of clinical data available. We report a case of patient whose insulin needs significantly
reduced from 64 units per day to 0 in 2 years after liver transplantation. A 38 year-old woman
had been initially diagnosed with liver cirrhosis; two years later, she was diagnosed with type 2
diabetes. And five years after the diagnosis, her glucose level was not adequately controlled
despite the use of exogenous insulin. At the age of 48, liver transplantation was required due to
intractable hepatic encephalopathy; since then, significant changes, as evidenced by fasting
plasma-insulin and homeostasis model assessment insulin resistance index, have been observed.
Therefore, the present case report provides additional data supporting that liver transplantation
may alleviate type 2 diabetes in patients with concurrent chronic liver disease, presumably due to
the change in insulin resistance, which appears to be a main underlying pathophysiologic feature
of hepatogenous diabetes. |
Key Words:
Hepatogenous diabetes,
Insulin resistance, Liver transplantation |
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