[Impaired glucose tolerance in liver and pancreas disease].

Impaired glucose tolerance(IGT) frequently occurs in patients with liver diseases. Because of the central role of the liver in carbohydrate metabolism, it is generally assumed that impaired hepatic metabolism plays a major role in the pathogenesis of IGT in liver disease. However, recent observation using glucose clamp techniques has demonstrated that the majority of patients with cirrhosis are characterized by peripheral hyperinsulinemia and insulin resistance of muscle tissues. Glucose intolerance in patients with chronic pancreatitis in related to impaired glucose-mediated insulin secretion, which is induced by the loss of B-cell mass in the pancreas. Patients with hemochromatosis have insulin resistance in the precirrhotic stage. The mechanism of insulin resistance, produced by iron overload, remains unknown.