[Clinical picture and pathogenesis of diabetes mellitus in chronic hepatitis and cirrhosis of the liver].

Peculiarities of clinical picture of diabetes mellitus in its combination with chronic hepatitis and cirrhosis of the liver were studied in 60 patients. Diabetes mellitus developed mostly against the background of chronic affection of the liver, preceding it. Glucose tolerance disturbances according to the type of latent and manifest diabetes were revealed in 28% of 132 patients with chronic hepatitis and cirrhosis of the liver. Histological study of the pancreas in 63 patients who died of cirrhosis of the liver demonstrated marked fibrosis of hepatic parenchyma without any noticeable changes in the pancreatic islets. The blood insulin and growth hormone levels were significantly greater in 132 patients examined than in healthy persons. The mentioned changes in the glycemia level, of the insulin and growth hormone level after glucose administration were more pronounced in cirrhosis of the liver than in chronic hepatitis, and in late stages of portal cirrhosis than at its early stages. The leading role played by insulin sensitivity reduction of the peripheral tissues in the pathogenesis of carbohydrate metabolism in cases with chronic diseases of the liver is supposed.